Individual provider Active NPI

Oksana Kroshna Zakinov, DDS

  • General Practice Dentistry
  • Sebastopol, CA
National Provider Identifier
1215424130
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104234 Issued in CA
Practice address
6800 Palm Ave Ste C1
Sebastopol, CA 95472-4251
Phone
(707) 869-2933
NPI assigned
Apr 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 104234 CA Primary

Addresses

Primary practice location

6800 Palm Ave Ste C1
Sebastopol, CA 95472-4251

Mailing address

6800 Palm Ave Ste C1
Sebastopol, CA 95472-4251
Phone (718) 683-4684

Other names 1

  • Oksana Kroshna Former name

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
104234CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1215424130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PALM AVE STE C1",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724251",
            "telephone_number": "718-683-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 PALM AVE STE C1",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724251",
            "telephone_number": "707-869-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKINOV",
        "first_name": "OKSANA",
        "middle_name": "KROSHNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OKSANA",
            "last_name": "KROSHNA",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.