Anna Kolentsova DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ANNA KOLENTSOVA DDS INC

Practice address

12043 Magnolia Blvd
Valley Village, CA 91607-2740

Phone

(818) 761-8274

NPI assigned

Oct 22, 2024

Organization subpart

No

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

Authorized official

Name

Anna Kolentsova, DDSNPI 1407459746

Title

President

Phone

(310) 430-2410

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Serene Dental Studio Doing business as

Locations

Practitioners 3

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

• Anna Kolentsova, DDS

  • Dentist
  • Valley Village, CA
  • NPI 1407459746
  NPD Authorized official
• Mark W Deering, D.D.S.

  • General Practice Dentistry
  • Valley Village, CA
  • NPI 1093721284
  NPD (past)
• Laura L Kadlec, D.D.S.

  • General Practice Dentistry
  • Valley Village, CA
  • NPI 1659421519
  NPD (past)

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1295556322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12043 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12043 MAGNOLIA BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072740",
            "telephone_number": "818-761-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA KOLENTSOVA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "KOLENTSOVA",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-430-2410",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407459746",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serene Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.