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Contact Information

ANDREY ANTONENKO, DDS
10 SIERRA GATE PLZ STE 190
ROSEVILLE, CA95678-6647
 Phone: 916-786-3303
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for ANDREY ANTONENKO · (Male)

NPI # 1144672874
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/06/2016
Last updated 11/06/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 100314
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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