Yelena Vinogradov, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS030310-L Issued in PA

Practice address

8539 Bustleton Ave
Philadelphia, PA 19152-1203

Phone

(215) 342-5750

Fax

(215) 646-6166

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1164593794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COMMERCE DR",
            "address_2": "SUITE 108",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342714",
            "telephone_number": "215-342-5750",
            "fax_number": "215-646-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8539 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521203",
            "telephone_number": "215-342-5750",
            "fax_number": "215-646-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINOGRADOV",
        "first_name": "YELENA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS030310-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001975883",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Holmberg Vining, D.D.S.
• Marvin Vinluan, CRNA
• Lisa Vinnacombe, MSS, MLSP, LCSW
• Christopher Lawrence Vinnard, M.D.
• Alexandra Miller Vinograd, MD
• Sophia S Vinogradovf, M.D.
• Emma Vinokur, BE
• Bryan Charles Vinski II, MS, CCC-SLP
• Liara Destiny Vinson, DDS
• Violet Bloom Therapy LLC

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.