Provider Demographics
NPI:1982292710
Name:KYKTA, IRYNA (DDS)
Entity Type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:KYKTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15655 HAWTHORNE BLVD STE A-B
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2665
Mailing Address - Country:US
Mailing Address - Phone:424-297-0513
Mailing Address - Fax:
Practice Address - Street 1:15655 HAWTHORNE BLVD STE A-B
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2665
Practice Address - Country:US
Practice Address - Phone:424-297-0513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1058881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice