Provider Demographics
NPI:1801074281
Name:ORYSHKEVYCH, YAROMYR (DDS)
Entity type:Individual
Prefix:
First Name:YAROMYR
Middle Name:
Last Name:ORYSHKEVYCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 POST OFFICE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1913
Mailing Address - Country:US
Mailing Address - Phone:301-843-3444
Mailing Address - Fax:301-843-3633
Practice Address - Street 1:605 POST OFFICE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-1913
Practice Address - Country:US
Practice Address - Phone:301-843-3444
Practice Address - Fax:301-843-3633
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD54851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice