Individual provider Active NPI

Jovanka Zivkovic

  • General Practice Dentistry
  • Astoria, NY
National Provider Identifier
1215334644
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
058354 Issued in NY
Practice address
3013 Steinway St
Astoria, NY 11103-3456
Phone
(718) 701-1225
Fax
(718) 701-1265
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 058354 NY Primary

Addresses

Primary practice location

3013 Steinway St
Astoria, NY 11103-3456

Mailing address

3013 Steinway St # 2R
Astoria, NY 11103-3456
Phone (718) 701-1225

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
058354NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Zivkovic Dentistry PC Current 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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1215334644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 STEINWAY ST # 2R",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033456",
            "telephone_number": "718-701-1225",
            "fax_number": "718-701-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3013 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033456",
            "telephone_number": "718-701-1225",
            "fax_number": "718-701-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIVKOVIC",
        "first_name": "JOVANKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.