Active NPI
Larisa Kushnir, DMD
- Dentist
- Philadelphia, PA
National Provider Identifier
1245681832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS040901
- Practice address
- 3131 Walnut St
Apt 451
Philadelphia, PA 19104-3415 - Phone
- (727) 642-7215
- NPI assigned
- Jun 25, 2016
- 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 | DS040901 | PA | Primary |
Addresses
Primary practice location
3131 Walnut St
Apt 451
Philadelphia, PA 19104-3415
Mailing address
3131 Walnut St
Apt 451
Philadelphia, PA 19104-3415
Phone (727) 642-7215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 8, 2025 through Jan 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS040901 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466812800000",
"number": "1245681832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3131 WALNUT ST",
"address_2": "APT 451",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043415",
"telephone_number": "727-642-7215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 WALNUT ST",
"address_2": "APT 451",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043415",
"telephone_number": "727-642-7215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSHNIR",
"first_name": "LARISA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-25",
"last_updated": "2016-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS040901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.