Provider Demographics
NPI:1629159843
Name:KULINICH, OKSANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:OKSANA
Middle Name:
Last Name:KULINICH
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 1:3609 MISSION AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2955
Mailing Address - Country:US
Mailing Address - Phone:916-488-5781
Mailing Address - Fax:916-488-5382
Practice Address - Street 1:3609 MISSION AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2955
Practice Address - Country:US
Practice Address - Phone:916-488-5781
Practice Address - Fax:916-488-5382
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB51951-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA203505313OtherTAX ID