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Individual
VADIM KHRAKOVSKY
Active
Individual
VADIM KHRAKOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
044343
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01360109
—
NY
01
—
5N3301
DELTA
NY
01
—
C1673
BCBS
NY
Enumeration date
10/20/2006
Last updated
03/07/2023
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