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General NPI Number Information
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NPI Number | 1982729778
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Entity Type | Individual
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Provider Name | TATYANA KOLODNER DDS
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 12215 VENTURA BLVD SUITE #115
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City | STUDIO CITY
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State | CA
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Zip | 91604-2533
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Country | US
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Telephone | 818-761-9526
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Fax | 818-755-6757
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Provider Business Mailing Address
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Address Line | 12215 VENTURA BLVD SUITE #115
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City | STUDIO CITY
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State | CA
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Zip | 91604-2533
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Country | US
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Telephone | 818-761-9526
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Fax | 818-755-6757
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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 | 44503
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 44503
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License Number State | CA
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