Provider Demographics
NPI:1356895163
Name:BYKOV, VLADISLAV
Entity type:Individual
Prefix:
First Name:VLADISLAV
Middle Name:
Last Name:BYKOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-6202
Mailing Address - Country:US
Mailing Address - Phone:605-321-7305
Mailing Address - Fax:
Practice Address - Street 1:3408 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-6202
Practice Address - Country:US
Practice Address - Phone:605-321-7305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No374U00000XNursing Service Related ProvidersHome Health Aide
No171R00000XOther Service ProvidersInterpreter
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No376J00000XNursing Service Related ProvidersHomemaker