Provider Demographics
NPI:1174366553
Name:BABENKO, KHRYSTYNA (DMD)
Entity type:Individual
Prefix:
First Name:KHRYSTYNA
Middle Name:
Last Name:BABENKO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2247 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1062
Mailing Address - Country:US
Mailing Address - Phone:727-379-9250
Mailing Address - Fax:
Practice Address - Street 1:2247 FOREST HILLS DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1062
Practice Address - Country:US
Practice Address - Phone:717-652-7995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN30910122300000X
PADS045411122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program