Dmitriy Vladimir Denissenko, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.4709 GD Issued in SC

Practice address

700 Rabon Rd
Columbia, SC 29203-8900

Phone

(803) 865-0645

Fax

(803) 865-5015

NPI assigned

Jun 15, 2010

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Richalnd Northeast Dental Associates,LLC

  • General Practice Dentistry
  • Columbia, SC
  • NPI 1295741056
  NPD (past)
• Richland Northeast Dental Associates,LLC

  • General Practice Dentistry
  • Chapin, SC
  • NPI 1952316473
  NPD (past)

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1184945008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 RABON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038900",
            "telephone_number": "803-865-0645",
            "fax_number": "803-865-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RABON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038900",
            "telephone_number": "803-865-0645",
            "fax_number": "803-865-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENISSENKO",
        "first_name": "DMITRIY",
        "middle_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.4709 GD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena McKeown
• Syreeta Dendy, NP-C
• Fang Emily Deng, M.D.,
• Erica Denham
• Jada Lashay Denis, RBT
• Leah Ruth Denman, LPC
• Dennis Dejesus MD PA
• Laurel Ann Dennis, PA
• Tolvalyn Shinia Dennison, CNS
• Howard Stone Denny Jr., DMD

• General Practice Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.