Healthcare Provider Details

I. General information

NPI: 1922021351
Provider Name (Legal Business Name): OKSANA BOYECHKO D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OKSANA GORKA D.M.D.

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 COACH LN STE 6
CAMERON PARK CA
95682-8406
US

IV. Provider business mailing address

3420 COACH LN STE 6
CAMERON PARK CA
95682-8406
US

V. Phone/Fax

Practice location:
  • Phone: 530-672-1616
  • Fax: 530-672-2380
Mailing address:
  • Phone: 530-672-1616
  • Fax: 530-672-2380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number57745
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN17423
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD7604
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: