MEDICARE: DR. POLINA BYKOVSKAYA DENTIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN27238	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548994759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. POLINA BYKOVSKAYA DENTIST

Provider Business Mailing Address
First Line	:	9878 CLINT MOORE RD STE 200
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-1037
Country	:	US
Telephone Number	:	561-852-7773
Fax Number	:

Provider Business Practice Location Address
First Line	:	8918 LANTANA RD STE B
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6136
Country	:	US
Telephone Number	:	347-742-0342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2022
Last Update Date	:	01/31/2025

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