Valeriy Kostenko, D. M. D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19585 Issued in MA

Practice address

74 Market St
Lynn, MA 01901-1115

Phone

(781) 581-1411

Fax

(781) 581-1433

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Dr.Kostenko D.M.D. P.C.

  • General Practice Dentistry
  • Lynn, MA
  • NPI 1417127671
  NPD (past) Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104969583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 MARKET ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011115",
            "telephone_number": "781-581-1411",
            "fax_number": "781-581-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 MARKET ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011115",
            "telephone_number": "781-581-1411",
            "fax_number": "781-581-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTENKO",
        "first_name": "VALERIY",
        "name_prefix": "Dr.",
        "credential": "D. M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0281956",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael B Koidin, D.D.S., M.SC.D.
• Smita B Kolli, M.D.
• Kelsey Elizabeth Komich, LCSW
• Fanwen Kong, LMHC
• Kornfeld Chiropractic Inc
• Yuliya Kostenko, DMD
• Olivia Rose Kostopoulos
• Suzanne Kramer, M.S., M.ED.
• Natalya Iosifovna Kravetskaya, D.M.D.
• Jacob Harry Krieger

• General Practice Dentistry in Lynn, MA
• Providers in Lynn, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.