Kristine Uzolina-Shportko

Primary specialty

DentistTaxonomy code 122300000X

License

059986 Issued in NY

Practice address

3645 Palisades Center Drive
West Nyack, NY 10994

Phone

(845) 353-3350

NPI assigned

May 1, 2017

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Practice roles

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

• Palisades Mall Dental LLP

  • Dentist
  • West Nyack, NY
  • NPI 1952601197
  NPD (past)

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1063948792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 PALISADES CENTER DRIVE",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "10994",
            "telephone_number": "845-353-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 PALISADES CENTER DRIVE",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "10994",
            "telephone_number": "845-353-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UZOLINA-SHPORTKO",
        "first_name": "KRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramesh Ubriani, M.D.
• Ugochukwu N Udogwu, MD
• Aisela Uli, OTR/L
• Patricia Lee Underwood, N.P.
• Bhoomi Upadhyaya, D.D.S.
• Santhamma Vaidian, REGISTERED NURSE
• Migdalia Valdes, LMSW
• Somsak Vanichpong
• Stanley Varghese, PT
• Usha Varghese, LPN

• Dentist in West Nyack, NY
• Providers in West Nyack, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.