Provider Demographics
NPI:1609486539
Name:PECHENY, MARIYA (DMD)
Entity Type:Individual
Prefix:
First Name:MARIYA
Middle Name:
Last Name:PECHENY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 RED MAPLE PL
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-7143
Mailing Address - Country:US
Mailing Address - Phone:607-621-9979
Mailing Address - Fax:
Practice Address - Street 1:880 37TH PL STE 4
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6506
Practice Address - Country:US
Practice Address - Phone:772-569-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist