Aleksey Kozlov, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD4950 Issued in NM

Practice address

2 Birch Rd
Cedar Crest, NM 87008-9553

Phone

(505) 281-2622

Fax

(505) 407-4044

NPI assigned

Jun 29, 2018

Last updated

Apr 2, 2025By 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

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aleksey Kozlov, D.M.D., LLC

  dba East Mountain Dentistry

  • Dental Clinic/Center
  • Cedar Crest, NM
  • NPI 1689262818
  NPD Authorized official
• Kidskare P.C.

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1316937964
  NPD (past)

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1124513288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 979",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870080979",
            "telephone_number": "505-281-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BIRCH RD",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089553",
            "telephone_number": "505-281-2622",
            "fax_number": "505-407-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOV",
        "first_name": "ALEKSEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Andrew Kan, MD
• Monique Y Keulen-Nolet, FNP RN MSN
• Tammie C Kiddy-Knight, MSW
• Callie Knapp, LCSW
• Courtney Kolb
• Stephen Alexander Lajoie, D.O.M.
• Sadie Jane Lewis
• Lisa Marie Stolarczyk MD PHD
• Jerome Arthur Lopez-Silva
• Amanda Macewen, OTR/L

• General Practice Dentistry in Cedar Crest, NM
• Providers in Cedar Crest, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.