MEDICARE: TRU DENTISTRY SOCO PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1558299545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRU DENTISTRY SOCO PLLC

Provider Business Mailing Address
First Line	:	3100 S CONGRESS AVE STE F
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-6463
Country	:	US
Telephone Number	:	512-737-7029
Fax Number	:	512-737-7026

Provider Business Practice Location Address
First Line	:	3100 S CONGRESS AVE STE F
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-6463
Country	:	US
Telephone Number	:	512-737-7029
Fax Number	:	512-737-7026

Authorized Official
Title or Position	:	OWNER
Name	:	NICHOLE KOSTIUK
Credential	:	DMD
Telephone Number	:	941-875-7002

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

Similar Medicare Providers

1982004172 — VICTORIA VALLEJO MD
Practice Location Address:

6463 AUSTIN ST APT 1A
REGO PARK, NY
11374-4089

Practice Phone: 718-975-5265
Practice Fax:

1912556853 — CYTHINA OSSELIN NP
Practice Location Address:

6463 AUSTIN ST APT 1A
REGO PARK, NY
11374-4089

Practice Phone: 516-414-6900
Practice Fax:

1649901364 — DESTINY RESIDENTIAL CARE SERVICES INC.
Practice Location Address:

600 BARWOOD PARK APT 1311
AUSTIN, TX
78753-6463

Practice Phone: 240-481-4000
Practice Fax:

1285312330 — SARAH TERNIER
Practice Location Address:

6463 AUSTIN ST APT 1A
REGO PARK, NY
11374-4089

Practice Phone: 718-464-3000
Practice Fax:

1902646607 — LACHIN SAPAROVA
Practice Location Address:

6463 AUSTIN ST
REGO PARK, NY
11374-4087

Practice Phone: 718-464-3000
Practice Fax:

1215109194 — DR. DAVID BATKIN YOUNGER PH.D
Practice Location Address:

2801 CEDARVIEW DR
AUSTIN, TX
78704-4606

Practice Phone: 914-330-6463
Practice Fax:

Directions to “TRU DENTISTRY SOCO PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.