Provider Demographics
NPI:1497225262
Name:ZHAMOITSINA, TATSIANA (RDHAP)
Entity Type:Individual
Prefix:
First Name:TATSIANA
Middle Name:
Last Name:ZHAMOITSINA
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21616 CALIFA ST APT 216
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4913
Mailing Address - Country:US
Mailing Address - Phone:323-695-2174
Mailing Address - Fax:
Practice Address - Street 1:21616 CALIFA ST APT 216
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-4913
Practice Address - Country:US
Practice Address - Phone:323-695-2174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP717124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist