Healthcare Provider Details

I. General information

NPI: 1326834284
Provider Name (Legal Business Name): YAN KALIKA DMD MS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8759 CENTER PKWY
SACRAMENTO CA
95823-7682
US

IV. Provider business mailing address

3075 BEACON BLVD
WEST SACRAMENTO CA
95691-3462
US

V. Phone/Fax

Practice location:
  • Phone: 916-259-9255
  • Fax: 916-384-3844
Mailing address:
  • Phone: 916-259-9255
  • Fax: 916-384-3844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: YAN KALIKA
Title or Position: OWNER
Credential: DMD MS
Phone: 916-259-9255