MEDICARE: YANINA SEMENENKOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	045245	NY

General Provider Information

NPI Number	:	1194714501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANINA SEMENENKOVA

Provider Business Mailing Address
First Line	:	2662 OCEAN AVE
Second Line	:	S.A-6
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4557
Country	:	US
Telephone Number	:	718-646-7271
Fax Number	:

Provider Business Practice Location Address
First Line	:	2662 OCEAN AVE
Second Line	:	S.A-6
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4557
Country	:	US
Telephone Number	:	718-646-7271
Fax Number	:	718-646-6664

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/08/2007

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Directions to “ YANINA SEMENENKOVA ” Practice Location

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