Aleksandra Komogortseva, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401418174 Issued in VA

Practice address

1934 Thomson Dr
Lynchburg, VA 24501-1028

Phone

(540) 315-3725

NPI assigned

Jun 15, 2020

Last updated

Aug 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crescent Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Dubuque, IA
  • NPI 1720146319
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1013532100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 W 129TH ST APT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100272105",
            "telephone_number": "347-339-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 THOMSON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011028",
            "telephone_number": "540-315-3725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kneeland St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111527",
            "country_code": "US",
            "telephone_number": "617-636-6641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1407 N Veterans Pkwy Ste 12",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617046425",
            "country_code": "US",
            "telephone_number": "309-233-3922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOMOGORTSEVA",
        "first_name": "ALEKSANDRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033985",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Bergeson Knight, M.D.
• Susan Knight
• Known Therapy LLC
• Thomas Eldon Knutson Jr., D.O.
• Justin Kolaya, LCSW
• Komorebi Psychotherapy, PLLC
• Peter L. Konieczny, M.D.
• Mary Koontz, RN, IBCLC
• Sharon J Kopis, FNP
• Anna Nicole Kostal, OTR/L

• General Practice Dentistry in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.