MEDICARE: VICTORIA OLSHANSKY D D S INC

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	122300000X	Dentist	46315	CA

General Provider Information

NPI Number	:	1194910588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORIA OLSHANSKY D D S INC

Provider Business Mailing Address
First Line	:	1136 N FAIRFAX AVE
Second Line	:
City	:	W HOLLYWOOD
State	:	CA
Zip	:	90046-5307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1136 N FAIRFAX AVE
Second Line	:
City	:	W HOLLYWOOD
State	:	CA
Zip	:	90046-5307
Country	:	US
Telephone Number	:	323-650-6936
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	VICTORIA OLSHANSKY
Credential	:
Telephone Number	:	323-650-6936

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	06/22/2021

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