Andrey Antonenko
Endodontist
10 Sierra Gate Plz Ste 190
Roseville
, California 95678-6647
Andrey Antonenko
Endodontist
10 Sierra Gate Plz Ste 190
Roseville
, California 95678-6647
(916) 786-3303
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Andrey Antonenko
- 10 Sierra Gate Plz Ste 190
- Roseville, CA
- Zip : 95678-6647
- Phone : (916) 786-3303
Second Address
- Andrey Antonenko
- 10 Sierra Gate Plz Ste 190
- Roseville, CA
- Zip : 95678-6647
- Phone : (916) 786-3303
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 100314 | CA |
National Provider Identifier
| NPI | 1144672874 |
|---|---|
| Provider Name | Andrey Antonenko |
| First Address | Roseville, CA 95678-6647 |
| Second Address | Roseville, CA 95678-6647 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/07/2016 |
| Last Update Date | 06/11/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.