Individual provider · NPI-1
Lauren Koroknay, RDH, OMT
Dental Hygienist · Ventura, CA
NPI number1700507290
StatusActive
Last updated in NPPESSep 5, 2022
Details
- NPI
- 1700507290
- Entity type
- Individual (NPI-1)
- Name
- Lauren Koroknay
- Credential
- RDH, OMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 5, 2022
- Certification date
- Sep 3, 2022
- Last updated
- Sep 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | 26766 | CA | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 299177 | CA |
Practice location
5472 Hunter StVentura, CA 93003-2231
Phone 805-766-9175
Mailing address
5472 Hunter StVentura, CA 93003-2231
Phone 805-766-9175
Other practice locations
92 Palm Dr
Camarillo, CA 93010-7964
Camarillo, CA 93010-7964
Phone 805-388-5700
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