Individual provider Active NPI

Vera Bolyshkanov, DDS

  • General Practice Dentistry
  • North Highlands, CA
National Provider Identifier
1295850154
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48233 Issued in CA
Practice address
6137 Watt Ave
Suite 8
North Highlands, CA 95660
Phone
(916) 331-7000
Fax
(916) 331-7007
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 48233 CA Primary

Addresses

Primary practice location

6137 Watt Ave
Suite 8
North Highlands, CA 95660

Mailing address

6137 Watt Ave
Ste 8
North Highlands, CA 95660
Phone (916) 331-7000

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

LicenseStateTypeSpecialty
48233CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elmira Abraamyan DDS General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295850154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6137 WATT AVE",
            "address_2": "STE 8",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "95660",
            "telephone_number": "916-331-7000",
            "fax_number": "916-331-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6137 WATT AVE",
            "address_2": "SUITE 8",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "95660",
            "telephone_number": "916-331-7000",
            "fax_number": "916-331-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLYSHKANOV",
        "first_name": "VERA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Highlands, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.