Provider Demographics
NPI:1548994759
Name:BYKOVSKAYA, POLINA (DENTIST)
Entity type:Individual
Prefix:DR
First Name:POLINA
Middle Name:
Last Name:BYKOVSKAYA
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9878 CLINT MOORE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1037
Mailing Address - Country:US
Mailing Address - Phone:561-852-7773
Mailing Address - Fax:
Practice Address - Street 1:8918 LANTANA RD STE B
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6136
Practice Address - Country:US
Practice Address - Phone:347-742-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN272381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice