Provider Demographics
NPI:1447284609
Name:OSTROVSKY, YELENA (DDS)
Entity type:Individual
Prefix:DR
First Name:YELENA
Middle Name:
Last Name:OSTROVSKY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-2606
Mailing Address - Country:US
Mailing Address - Phone:415-929-4848
Mailing Address - Fax:415-614-0470
Practice Address - Street 1:3208 SCOTT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-2606
Practice Address - Country:US
Practice Address - Phone:415-929-4848
Practice Address - Fax:415-614-0470
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice