DR. YELENA VLADIMIROVNA GUTNICHENKO (NPI# 1174553481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174553481 |
| Entity Type | Individual |
| Full Name | DR. YELENA VLADIMIROVNA GUTNICHENKO |
| Credential | D.M.D. |
| Practice Address |
695 Main St Waltham MA 02451-0609 |
| Practice Telephone | 7818997070 |
| Practice Fax Number | 7818991802 |
| Mailing Telephone | 7818997070 |
| Mailing Fax Number | 7818991802 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-01-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
20567 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0202576 | 05 |
| Street Address |
695 MAIN ST |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-0609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801043138 | Carmen D. Brambila | Dentist | 695 Main St, Waltham, MA 02451-0609 | 2008-08-18 |
| 1184768426 | Children's Dental of Waltham, P.C. | Dentist | 695 Main St, Waltham, MA 02451-0609 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1184030066 | Weichun Li | Dentist | 85 River St # 65292, Waltham, MA 02453-8300 | 2014-07-11 |
| 1295013662 | Charles Sutera IIi | Dentist | 75 3rd Ave, Waltham, MA 02451-7549 | 2011-08-02 |
| 1356563035 | Mikhail Shulkin Dds PC | Dentist | 509 Moody Street, Waltham, MA 02453 | 2007-05-03 |
| 1104978220 | Edward Morton | Dentist | 633 Trapelo Rd, Waltham, MA 02452-7921 | 2007-01-17 |
| 1841347457 | Alan David Nesson | Dentist | 549 Lexington St, Waltham, MA 02452-3005 | 2007-01-04 |
| 1396805313 | Tam Tang and Sham PC | Dentist | 85 River Street, Waltham, MA 02453 | 2006-12-11 |
| 1023101300 | Tacuhi Sona Tacvorian | Dentist | 24 Crescent St, # 302, Waltham, MA 02453-4358 | 2006-10-01 |
| 1326052465 | John George Valentino | Dentist | 965 Trapelo Rd, Waltham, MA 02452-4842 | 2006-07-27 |
| 1881615680 | John Francis Giglio IIi | Dentist | 66 South St, Waltham, MA 02453 | 2006-07-21 |
| Find all providers in WALTHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.