Healthcare Provider Details

I. General information

NPI: 1184536807
Provider Name (Legal Business Name): YAN KALIKA DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 SANTA CLARA AVE
ALAMEDA CA
94501-2515
US

IV. Provider business mailing address

1740 SANTA CLARA AVE
ALAMEDA CA
94501-2515
US

V. Phone/Fax

Practice location:
  • Phone: 916-702-1213
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: AYREN ENGELHARDT
Title or Position: DIR OF PROCESS DEV
Credential:
Phone: 916-702-1213