Individual provider Active NPI

Tatyana V Kvyatkovskaya, DDS

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1184869562
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56308 Issued in CA
Practice address
4585 Mission St
San Francisco, CA 94112-2603
Phone
(415) 584-8500
NPI assigned
Dec 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 56308 CA Primary

Addresses

Primary practice location

4585 Mission St
San Francisco, CA 94112-2603

Mailing address

258 Denslowe Dr
San Francisco, CA 94132-2648
Phone (415) 586-8602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
56308CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Roytman &Morozova Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1184869562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 DENSLOWE DR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941322648",
            "telephone_number": "415-586-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941122603",
            "telephone_number": "415-584-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVYATKOVSKAYA",
        "first_name": "TATYANA",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-12",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; 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.