DR. IGOR MARYANCHIK (NPI# 1265644769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265644769 |
| Entity Type | Individual |
| Full Name | DR. IGOR MARYANCHIK |
| Credential | DDS |
| Practice Address |
2450 Pepperrell Street 59dts-mrde Lackland Afb TX 78236-5345 |
| Mailing Address |
659 Lynx Mountain San Antonio TX 78251 |
| Practice Telephone | 2102926705 |
| Mailing Telephone | 7035996416 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS030703L | PA | Dental Providers |
| Street Address |
2450 PEPPERRELL STREET 59DTS-MRDE |
| City | LACKLAND AFB |
| State | TX |
| Zip Code | 78236-5345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225259393 | Joshua Matthew Hethcox | Dentist | 2450 Pepperrell Street, Lackland Afb, TX 78236 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1508208059 | Rachel E. Lewin | Dentist | Air Force Postgraduate Dental School - Orthodontics, 2133 Pepperrell St, Lackland Afb, TX 78236 | 2013-07-25 |
| 1831346212 | Karen Randi Lapham | Dentist | 1615 Truemper St Rm B119, Lackland Afb, TX 78236-5511 | 2008-08-27 |
| 1225259393 | Joshua Matthew Hethcox | Dentist | 2450 Pepperrell Street, Lackland Afb, TX 78236 | 2007-05-02 |
| 1568434611 | Dennis Carl Dixon | Dentist | 220 Berquist Dr, Ste 1, Attn: Credentials (cmc), Lackland Afb, TX 78236-5300 | 2006-02-03 |
| 1447605886 | William Grosdidier | Dentist | 1615 Truemper St, Lackland Afb, TX 78236-5511 | 2016-05-03 |
| 1285924407 | Hannah Colburn Drew | Dentist | 2133 Pepperrell St, Bldg 3352, 59 Dg - Afpds, Lackland Afb, TX 78236-5313 | 2011-04-08 |
| 1518189521 | Janeen Hughes | Dentist | 2450 Pepperrell St, Lackland Afb, TX 78236-5345 | 2007-05-02 |
| 1619966082 | Brian Michael Clement | Dentist | 2450 Pepperrell St, Lackland Afb, TX 78236-5345 | 2005-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1659971653 | Richardson Heights Dental, Pllc | Dentist | 721 W Arapaho Rd Ste 101, Richardson, TX 75080-4155 | 2020-10-28 |
| 1053911396 | Ko Dental Group, PC | Dentist | 302 S. Avenue Q, Clifton, TX 76634 | 2020-10-27 |
| 1972103240 | Kla Dr Pllc | Dentist | 2100 Dallas Pkwy Ste 120, Plano, TX 75093-4394 | 2020-10-27 |
| 1255930798 | Jpm Dental Conroe | Dentist | 2104 N Frazier St Ste 140, Conroe, TX 77301-1250 | 2020-10-24 |
| 1407455173 | Perla Dental of Kaufman Pa | Dentist | 380 E Us Highway 175, Kaufman, TX 75142-3548 | 2020-10-22 |
| 1497354179 | Perla Dental of Keller Pa | Dentist | 5325 Golden Triangle Blvd Ste 100, Fort Worth, TX 76244-4469 | 2020-10-22 |
| 1770182701 | Summit Point Dental & Implant Center | Dentist | 3124 West University Drive, Mckinney, TX 75071-7507 | 2020-10-21 |
| 1760081954 | Amlan Pankaj | Dentist | 802 E Amarillo Blvd # 300, Amarillo, TX 79107-5401 | 2020-10-20 |
| 1114525581 | Ashley Roy | Dentist | 9099 Katy Fwy Ste 180, Houston, TX 77024-1677 | 2020-10-16 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND AFB |
| Zip Code | 78236 |
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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.