Provider Demographics
NPI:1730536863
Name:EKATERINA TOMENKO DDS LLC
Entity type:Organization
Organization Name:EKATERINA TOMENKO DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:EKATERINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TOMENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-439-8333
Mailing Address - Street 1:10230 NEW HAMPSHIRE AVENUE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903
Mailing Address - Country:US
Mailing Address - Phone:301-439-8333
Mailing Address - Fax:301-439-4622
Practice Address - Street 1:10230 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1400
Practice Address - Country:US
Practice Address - Phone:301-439-8333
Practice Address - Fax:301-439-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14794122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty