Provider Demographics
NPI:1225838576
Name:MATCHENKO, KATERYNA (DMD)
Entity type:Individual
Prefix:
First Name:KATERYNA
Middle Name:
Last Name:MATCHENKO
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:KATERYNA
Other - Middle Name:
Other - Last Name:YARKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:12 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7933
Mailing Address - Country:US
Mailing Address - Phone:269-861-4995
Mailing Address - Fax:
Practice Address - Street 1:1290 TREMONT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120-3432
Practice Address - Country:US
Practice Address - Phone:617-989-3240
Practice Address - Fax:617-858-2664
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL100733124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist