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General NPI Number Information
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NPI Number | 1811880271
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Entity Type | Organization
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Legal Business Name | ALEKSANDR YANCHUK DMD LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 16400 SW HART RD STE A
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City | BEAVERTON
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State | OR
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Zip | 97007-3457
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Country | US
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Telephone | 503-649-7701
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Fax |
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Provider Business Mailing Address
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Address Line | 12057 SW LAUSANNE ST
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City | WILSONVILLE
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State | OR
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Zip | 97070-7381
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Country | US
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Telephone | 503-875-3426
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Fax |
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Authorized Official
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Title or Position | DENTIST/ OWNER
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Name | DR. ALEKSANDR YANCHUK
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Credential | DMD
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Telephone | 503-875-3426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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