Daniel Kovacik, D.M.D., M.P.H

Primary specialty

DentistTaxonomy code 122300000X

License

D008345 Issued in AZ

Practice address

11641 N 23Rd St
Phoenix, AZ 85028-1705

Phone

(480) 250-4461

NPI assigned

Dec 21, 2011

Last updated

Nov 12, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• An Elegant Smile, P.C.

  dba An Elegant Smile Dentistry

  • Oral and Maxillofacial Surgery (Dentist)
  • Phoenix, AZ
  • NPI 1275565871
  NPD (past)

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1033488093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E BELL RD",
            "address_2": "SUITE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850226639",
            "telephone_number": "602-867-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11641 N 23RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281705",
            "telephone_number": "480-250-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACIK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-21",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D008345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jo Kouten, BSN, RN
• Stacy Koutrakos, PSY.D.
• Aaron Kovac, D.C.
• Stephanie Kovach
• Angela Herro Kovacik, MD
• Jennifer A Kovacik, M.D.
• Shannon M Kovalcik, NP
• Christina M Kovalik, NMD
• Melissa Kovar, DPT
• David Koven, DO

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.