Provider Demographics
NPI:1740584481
Name:TOMENKO, EKATERINA (DDS)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:TOMENKO
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 1:10230 NEW HAMPSHIRE AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1418
Mailing Address - Country:US
Mailing Address - Phone:301-439-8333
Mailing Address - Fax:301-439-4622
Practice Address - Street 1:10230 NEW HAMPSHIRE AVE STE 330
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1418
Practice Address - Country:US
Practice Address - Phone:301-439-8333
Practice Address - Fax:301-439-4622
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD147941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice