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General NPI Number Information
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NPI Number | 1720516685
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Entity Type | Individual
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Provider Name | OKSANA VALENTINOVNA SOMCHENKO DMD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 424 S MONROE AVE
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City | GREEN BAY
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State | WI
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Zip | 54301-4054
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Country | US
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Telephone | 920-544-0346
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Fax |
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Provider Business Mailing Address
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Address Line | 419 E LE CAPITAINE CIR
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City | GREEN BAY
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State | WI
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Zip | 54302-5152
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Country | US
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Telephone | 920-713-8978
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 1001784-15
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License Number State | WI
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