Joe Koliadko, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

AK1042 Issued in AK

Practice address

4201 Tudor Centre Dr
Suite 320
Anchorage, AK 99508-5904

Phone

(907) 317-6070

Fax

(806) 794-1919

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Southcentral Foundation Dental Dhat

  • Dental Clinic/Center
  • Anchorage, AK
  • NPI 1962726364
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235151374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196320",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995195904",
            "telephone_number": "907-317-6070",
            "fax_number": "806-794-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 TUDOR CENTRE DR",
            "address_2": "SUITE 320",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085904",
            "telephone_number": "907-317-6070",
            "fax_number": "806-794-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLIADKO",
        "first_name": "JOE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "AK1042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD2889",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1471866",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John F Kokesh, M.D.
• Barbara Kolb, M.S. LPC
• Katherine L Kolb, MD
• Joseph C Kolba, MD
• Armand Kolberg II, CDC1
• Mariia Kolisnyk
• Denise Ann Kolojejchick-Coslett, PA-C
• America Komakhuk
• Leanne Komorowski, M.D.
• Aleric Kompkoff-Anderson

• Dentist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.