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General NPI Number Information
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NPI Number | 1104433796
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Entity Type | Individual
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Provider Name | IRENA STARCHENKO DDS
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Gender | Female
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 2007 WILSHIRE BLVD STE 525
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City | LOS ANGELES
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State | CA
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Zip | 90057-3518
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Country | US
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Telephone | 213-858-4007
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 S GARTH AVE
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City | LOS ANGELES
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State | CA
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Zip | 90034-1506
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Country | US
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Telephone | 347-825-1294
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 105479
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License Number State | CA
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