Provider Demographics
NPI:1255590923
Name:DOROSHENKO, ARINA SERGEEVNA (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:ARINA
Middle Name:SERGEEVNA
Last Name:DOROSHENKO
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:
Other - First Name:ARINA
Other - Middle Name:SERGEEVNA
Other - Last Name:KONDRAKHINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2922 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5627
Mailing Address - Country:US
Mailing Address - Phone:813-336-2563
Mailing Address - Fax:
Practice Address - Street 1:2922 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5627
Practice Address - Country:US
Practice Address - Phone:813-336-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD143381223S0112X
FLDN230561223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery