Individual provider Active NPI

Ronald Ira Koslowski, DDS

  • Prosthodontics
  • Encino, CA
National Provider Identifier
1194870501
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
39291 Issued in CA
Practice address
16311 Ventura Blvd
Suite 985
Encino, CA 91436-2124
Phone
(818) 986-9036
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 39291 CA Primary

Addresses

Primary practice location

16311 Ventura Blvd
Suite 985
Encino, CA 91436-2124

Mailing address

16311 Ventura Blvd
Suite 985
Encino, CA 91436-2124
Phone (818) 986-9036

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111129000380 CA Practitioner - Oral Surgery 8729252853 Practice locations: Encino, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39291CAMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194870501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "SUITE 985",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-986-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "SUITE 985",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "818-986-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSLOWSKI",
        "first_name": "RONALD",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "39291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.