Individual provider Active NPI

Steven Dean Svetcov, DENTIST

  • Endodontics
  • Oakland Gardens, NY
National Provider Identifier
1124087283
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
034410 Issued in NY
Practice address
20906 Union Tpke
Oakland Gardens, NY 11364
Phone
(718) 479-9400
Fax
(718) 479-8084
NPI assigned
Mar 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 034410 NY Primary

Addresses

Primary practice location

20906 Union Tpke
Oakland Gardens, NY 11364

Mailing address

20906 Union Tpke
Oakland Gardens, NY 11364
Phone (718) 479-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140124001332 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799913554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1124087283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20906 UNION TPKE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "718-479-9400",
            "fax_number": "718-479-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20906 UNION TPKE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "718-479-9400",
            "fax_number": "718-479-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVETCOV",
        "first_name": "STEVEN",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "034410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Gardens, NY

Sources for this page

Verify at the official NPI Registry.