Provider Demographics
NPI:1790090660
Name:VOLOSHCHENKO, TATYANA V (DDS)
Entity Type:Individual
Prefix:DR
First Name:TATYANA
Middle Name:V
Last Name:VOLOSHCHENKO
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 1:230 E 30TH ST
Mailing Address - Street 2:APT 15 D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8236
Mailing Address - Country:US
Mailing Address - Phone:502-836-3603
Mailing Address - Fax:
Practice Address - Street 1:230 E 30TH ST
Practice Address - Street 2:APT 15 D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8236
Practice Address - Country:US
Practice Address - Phone:502-836-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY500551791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice