ANDREY ANTONENKO (NPI# 1144672874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144672874 |
Entity Type | Individual |
Full Name | ANDREY ANTONENKO |
Credential | DDS |
Practice Address |
10 Sierra Gate Plz Ste 190 Roseville CA 95678-6647 |
Practice Telephone | 9167863303 |
Mailing Telephone | 9167863303 |
Enumeration Date | 2016-07-06 |
Last Update Date | 2020-11-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223E0200X |
Dentist Specialization: Endodontics |
100314 | CA | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912460536 | Andrey Antonenko | Counselor | 7281 Garden Grove Blvd Ste H, Garden Grove, CA 92841-4212 | 2019-04-10 |
Street Address |
10 SIERRA GATE PLZ STE 190 |
City | ROSEVILLE |
State | CA |
Zip Code | 95678-6647 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
Find all providers in zip 95678 |
Taxonomy Code | 1223E0200X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Endodontics |
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316221674 | Dwyer & Dow, A Dental Corp. | Dentist | 730 Sunrise Avenue #110, Roseville, CA 95661-4549 | 2011-10-05 |
1922296391 | Bruce M. Holt, D.d.s., Inc. | Dentist | 1421 Secret Ravine Pkwy., Suite 101, Roseville, CA 95661 | 2007-10-10 |
1740357706 | James Robert Dow | Dentist | 730 Sunrise Ave, Suite 110, Roseville, CA 95661-4549 | 2006-11-28 |
1275617367 | Thomas George Dwyer | Dentist | 730 Sunrise Avenue, #110, Roseville, CA 95661-4549 | 2006-10-25 |
1659936441 | Wdwrosevillepllc | Dentist | 21055 E 12 Mile Rd, Roseville, MI 48066-2205 | 2019-05-07 |
1962888354 | Pacharee Kulwattanaporn | Dentist | 18303 E 10 Mile Rd, Suite 150, Roseville, MI 48066-4988 | 2015-08-07 |
1851772362 | Dental Specialists of Minnesota, Pllc | Dentist | 2200 County Road C W, Suite 2210, Roseville, MN 55113-2550 | 2015-06-11 |
1891933875 | Edmond Kenneth Chow | Dentist | 2420 Professional Dr, Roseville, CA 95661-7773 | 2009-01-28 |
1194980284 | Kevin J. O'neill, D.d.s., M.s.d., Inc. | Dentist | 10 Sierra Gate Plz, Suite #190, Roseville, CA 95678-6645 | 2008-07-28 |
1649397480 | Kevin M O'dea | Dentist | 10 Sierra Gate Plz, Suite 190, Roseville, CA 95678-6645 | 2007-03-25 |
Find all providers in ROSEVILLE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.