Provider Demographics
NPI:1922021351
Name:BOYECHKO, OKSANA (DMD)
Entity Type:Individual
Prefix:
First Name:OKSANA
Middle Name:
Last Name:BOYECHKO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:OKSANA
Other - Middle Name:
Other - Last Name:GORKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3420 COACH LN STE 6
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8406
Mailing Address - Country:US
Mailing Address - Phone:530-672-1616
Mailing Address - Fax:530-672-2380
Practice Address - Street 1:3420 COACH LN STE 6
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8406
Practice Address - Country:US
Practice Address - Phone:530-672-1616
Practice Address - Fax:530-672-2380
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD76041223G0001X
CA57745122300000X
FLDN17423122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice