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NPI Code Detail

MEDICARE: TATYANA KOLODNER DDS

MEDICARE: TATYANA KOLODNER DDS
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
1122300000XDentist44503CA
21223G0001XGeneral Practice Dentistry44503CA

General Provider Information

NPI Number : 1982729778
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATYANA KOLODNER DDS
Provider Business Mailing Address
First Line : 12215 VENTURA BLVD
Second Line : SUITE #115
City : STUDIO CITY
State : CA
Zip : 91604-2533
Country : US
Telephone Number : 818-761-9526
Fax Number : 818-755-6757
Provider Business Practice Location Address
First Line : 12215 VENTURA BLVD
Second Line : SUITE #115
City : STUDIO CITY
State : CA
Zip : 91604-2533
Country : US
Telephone Number : 818-761-9526
Fax Number : 818-755-6757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 11/08/2013

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Directions to “ TATYANA KOLODNER DDS” Practice Location

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