Maryna Kozyryev

Primary specialty

DentistTaxonomy code 122300000X

License

104251 Issued in CA

Practice address

11670 Atwood Rd
Auburn, CA 95603-9522

Phone

(530) 887-2800

NPI assigned

Apr 4, 2018

Sex

Female

Sole proprietor

Yes

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 CA

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

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 and National Provider Directory roles.

• Maryna Kozyryev DDS Inc

  • Dental Clinic/Center
  • Citrus Heights, CA
  • NPI 1447862123
  NPD Authorized official

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598140800000",
    "number": "1184120487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7761 APTOS CIR",
            "city": "CITRUS HTS",
            "state": "CA",
            "postal_code": "956104540",
            "telephone_number": "916-248-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522",
            "telephone_number": "530-887-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZYRYEV",
        "first_name": "MARYNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2020-08-23",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Koinonia Foster Homes, Inc.
• Kristin Pungrchar Kolster, M.A.
• Peter Korn, RDHAP
• Steven D Korosec
• Tatiana Korshunova, MD
• Marlene Sue Kramer, F.N.P.
• Sandra L Kranzler
• David Richard Kraus, RPH
• Karen Ann Krause, PHYSICAL THERAPIST
• Kenneth James Kroger, MD

• Dentist in Auburn, CA
• Providers in Auburn, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2020; 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.