Provider Demographics
NPI:1023892759
Name:BYAKINA, OLGA (DDS)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:BYAKINA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MADISON AVE APT 502
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2769
Mailing Address - Country:US
Mailing Address - Phone:415-238-8262
Mailing Address - Fax:
Practice Address - Street 1:240 MADISON AVE APT 502
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2769
Practice Address - Country:US
Practice Address - Phone:415-238-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1059681223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics