Individual provider Active NPI

Elena Andrea Androsov

  • Dental Hygienist
  • Vancouver, WA
National Provider Identifier
1083519714
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH61577316 Issued in WA
Practice address
16701 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4306
Phone
(360) 803-2722
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH61577316 WA Primary

Addresses

Primary practice location

16701 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4306

Mailing address

16701 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4306
Phone (360) 803-2722

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1083519714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16701 SE MCGILLIVRAY BLVD STE 175",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834306",
            "telephone_number": "360-803-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16701 SE MCGILLIVRAY BLVD STE 175",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834306",
            "telephone_number": "360-803-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDROSOV",
        "first_name": "ELENA",
        "middle_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH61577316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.