Healthcare Provider Details

I. General information

NPI: 1578073714
Provider Name (Legal Business Name): COREY STEVEN BOYKO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7350 STATE ROAD
PARMA OH
44134
US

IV. Provider business mailing address

5851 PEARL RD STE 100
PARMA HEIGHTS OH
44130-2112
US

V. Phone/Fax

Practice location:
  • Phone: 440-885-0038
  • Fax: 440-885-5611
Mailing address:
  • Phone: 440-885-0038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.025030
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: