Individual provider Active NPI

Albert B. Konikoff, DDS

  • Periodontics
  • Virginia Beach, VA
National Provider Identifier
1144228719
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
4445 Issued in VA
Practice address
477 Viking Dr
Virginia Beach, VA 23452-7354
Phone
(757) 486-8181
Fax
(757) 463-0148
NPI assigned
Jul 8, 2005
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 4445 VA Primary

Addresses

Primary practice location

477 Viking Dr
Virginia Beach, VA 23452-7354

Mailing address

1018 Dartford Mews
Virginia Beach, VA 23452-6160
Phone (757) 486-2796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Oct 8, 2012 through Oct 8, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4445VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Konikoff Periodontics LTD Periodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1144228719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 DARTFORD MEWS",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526160",
            "telephone_number": "757-486-2796",
            "fax_number": "757-463-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 VIKING DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527354",
            "telephone_number": "757-486-8181",
            "fax_number": "757-463-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIKOFF",
        "first_name": "ALBERT",
        "middle_name": "B.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "4445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.