Healthcare Provider Details

I. General information

NPI: 1093481053
Provider Name (Legal Business Name): DARYNA ALEXANDRA KUTUZA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3859 NAZARETH PIKE STE 202&203
BETHLEHEM PA
18020-1102
US

IV. Provider business mailing address

1018 FEHNEL DR
EASTON PA
18045-2045
US

V. Phone/Fax

Practice location:
  • Phone: 610-419-0088
  • Fax:
Mailing address:
  • Phone: 267-972-6557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS043381
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: