Provider Demographics
NPI:1598218596
Name:KUCHMAK, YURIY (DMD)
Entity type:Individual
Prefix:DR
First Name:YURIY
Middle Name:
Last Name:KUCHMAK
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2996 EXECUTIVE DRIVE
Mailing Address - Street 2:UNIT 102
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292
Mailing Address - Country:US
Mailing Address - Phone:941-477-1620
Mailing Address - Fax:941-477-1623
Practice Address - Street 1:2996 EXECUTIVE DRIVE
Practice Address - Street 2:UNIT 102
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292
Practice Address - Country:US
Practice Address - Phone:941-477-1620
Practice Address - Fax:941-477-1623
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN219321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice