Healthcare Provider Details

I. General information

NPI: 1548994759
Provider Name (Legal Business Name): POLINA BYKOVSKAYA DENTIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 FAIRWAY DR STE 59
PALM BEACH GARDENS FL
33418-3779
US

IV. Provider business mailing address

7100 FAIRWAY DR STE 59
PALM BEACH GARDENS FL
33418-3779
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-8666
  • Fax:
Mailing address:
  • Phone: 561-627-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN27238
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: