NPIMap

Organization Active NPI

Mobile Outreach Alliance

  • Dental Hygienist
  • Arvada, CO
National Provider Identifier
1265067425
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
Legal business name
MOBILE OUTREACH ALLIANCE
Practice address
8422 W 78TH Cir
Arvada, CO 80005-4407
Phone
(303) 506-4698
NPI assigned
Mar 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Authorized official

Name
Olga Romanovna KoganNPI 1568893345
Title
Ceo
Phone
(303) 506-4698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0001X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X Primary
Public Health or Welfare Agency 251K00000X

Addresses

Primary practice location

8422 W 78TH Cir
Arvada, CO 80005-4407

Mailing address

8422 W 78TH Cir
Arvada, CO 80005-4407
Phone (303) 506-4698

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2225876Mobile Outreach Alliance8422 West 78TH Circle, Arvada, CO 80005Certificate of waiverMay 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1265067425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8422 W 78TH CIR",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800054407",
            "telephone_number": "303-506-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8422 W 78TH CIR",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800054407",
            "telephone_number": "303-506-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE OUTREACH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "KOGAN",
        "authorized_official_first_name": "OLGA",
        "authorized_official_middle_name": "ROMANOVNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-506-4698"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.