Healthcare Provider Details

I. General information

NPI: 1366350431
Provider Name (Legal Business Name): ELENA RUMACK, D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23622 CALABASAS RD STE 101
CALABASAS CA
91302-1584
US

IV. Provider business mailing address

23622 CALABASAS RD STE 101
CALABASAS CA
91302-1584
US

V. Phone/Fax

Practice location:
  • Phone: 818-222-4543
  • Fax: 818-222-4547
Mailing address:
  • Phone: 818-222-4543
  • Fax: 818-222-4547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: IVAN MARCAL
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 818-222-4543