Individual provider Active NPI

Olga Byakina, DDS

  • Periodontics
  • Memphis, TN
National Provider Identifier
1023892759
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
105968 Issued in CA
Practice address
240 Madison Ave Apt 502
Memphis, TN 38103-2769
Phone
(415) 238-8262
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 105968 CA Primary

Addresses

Primary practice location

240 Madison Ave Apt 502
Memphis, TN 38103-2769

Mailing address

240 Madison Ave Apt 502
Memphis, TN 38103-2769
Phone (415) 238-8262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105968CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1023892759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MADISON AVE APT 502",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032769",
            "telephone_number": "415-238-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MADISON AVE APT 502",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032769",
            "telephone_number": "415-238-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYAKINA",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "105968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.