Provider Demographics
NPI:1427251644
Name:KALIKA, YAN (DMD,MS)
Entity type:Individual
Prefix:DR
First Name:YAN
Middle Name:
Last Name:KALIKA
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 BEACON BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-3462
Mailing Address - Country:US
Mailing Address - Phone:916-297-6600
Mailing Address - Fax:916-848-0455
Practice Address - Street 1:3412 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3326
Practice Address - Country:US
Practice Address - Phone:415-752-0654
Practice Address - Fax:916-848-0455
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458861223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA202732530OtherORTHODONTICS