Active NPI
Kateryna Nechay
- Dentist
- Forest Lake, MN
National Provider Identifier
1225695893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14175
- Practice address
- 107 12TH St SW Ste 2
Forest Lake, MN 55025-1467 - Phone
- (651) 964-2013
- NPI assigned
- May 20, 2019
- Last updated
- May 20, 2019
- Sex
- Female
- Sole proprietor
- No
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 | D14175 | MN | Primary |
Addresses
Primary practice location
107 12TH St SW Ste 2
Forest Lake, MN 55025-1467
Mailing address
107 12TH St SW Ste 2
Forest Lake, MN 55025-1467
Phone (651) 964-2013
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
| License | State | Type | Specialty |
|---|---|---|---|
| D14175 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minnesota Dental Professionals, P.C. | 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.
-
dba Southwest Dental Care
- General Practice Dentistry
- Forest Lake, MN
- NPI 1619451192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1225695893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 12TH ST SW STE 2",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550251467",
"telephone_number": "651-964-2013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 12TH ST SW STE 2",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550251467",
"telephone_number": "651-964-2013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NECHAY",
"first_name": "KATERYNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-20",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.