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General NPI Number Information
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NPI Number | 1689449001
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Entity Type | Individual
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Provider Name | IRYNA TYTYK DMD
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Gender | Female
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 6289 PGA BLVD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-4000
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Country | US
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Telephone | 561-486-8897
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 SW 7TH CT
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City | BOCA RATON
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State | FL
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Zip | 33486-7036
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Country | US
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Telephone | 954-612-8688
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18351
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN28475
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License Number State | FL
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