Provider Demographics
NPI:1356950232
Name:YURCHAK, VALERIYA (DMD)
Entity type:Individual
Prefix:DR
First Name:VALERIYA
Middle Name:
Last Name:YURCHAK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 AMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-4803
Mailing Address - Country:US
Mailing Address - Phone:916-837-5030
Mailing Address - Fax:
Practice Address - Street 1:825 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-2201
Practice Address - Country:US
Practice Address - Phone:916-372-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105060122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist