Provider Demographics
NPI:1467677674
Name:KUZNETSOVA, YANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:YANA
Middle Name:
Last Name:KUZNETSOVA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1401
Mailing Address - Country:US
Mailing Address - Phone:210-551-7713
Mailing Address - Fax:
Practice Address - Street 1:6565 BABCOCK RD STE 11
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2345
Practice Address - Country:US
Practice Address - Phone:210-904-2888
Practice Address - Fax:210-549-0040
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21523122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist