Active NPI
Olga Krikunenko
- Dentist
- Quincy, MA
National Provider Identifier
1184970766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1856109
- Practice address
- 1518 Hancock St
Quincy, MA 02169-5205 - Phone
- (617) 471-3600
- NPI assigned
- Aug 1, 2012
- Last updated
- Aug 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1856109 | MA | Primary |
Addresses
Primary practice location
1518 Hancock St
Quincy, MA 02169-5205
Mailing address
214 Sherman Rd
Chestnut Hill, MA 02467-3180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160608002377 | MA | Order and Referring Only - Dentist | 0547550238 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 42 North Dental Care, LLC | 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": "1343779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343779200000",
"number": "1184970766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 SHERMAN RD",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024673180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1518 HANCOCK ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021695205",
"telephone_number": "617-471-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIKUNENKO",
"first_name": "OLGA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-01",
"last_updated": "2012-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1856109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.