Healthcare Provider Details

I. General information

NPI: 1093656076
Provider Name (Legal Business Name): OLESYA TELENKO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 DANBURY RD
RIDGEFIELD CT
06877-3227
US

IV. Provider business mailing address

10240 67TH DR APT 6F
FOREST HILLS NY
11375-2819
US

V. Phone/Fax

Practice location:
  • Phone: 203-431-4300
  • Fax: 203-431-6733
Mailing address:
  • Phone: 347-203-7146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14802
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: