Elizabeth T Prishkulnik, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DD2707 Issued in NM

Practice address

490B W Zia Rd
Santa Fe, NM 87505-7008

Phone

(505) 428-7878

NPI assigned

Oct 11, 2005

Last updated

Jun 29, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Just for Grins

  • Pediatric Dentistry
  • Santa Fe, NM
  • NPI 1801074257
  NPD (past) Authorized official

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1306834676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490B W ZIA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057008",
            "telephone_number": "505-428-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490B W ZIA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057008",
            "telephone_number": "505-428-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRISHKULNIK",
        "first_name": "ELIZABETH",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "04805",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD2707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Price, LPCC
• Ashley Prickett, DPT
• Marcus D Prieskop, EMT-P
• John Timmis Prigmore
• Priority Physical Therapy NM
• Pro-Active Chiropractic LLC
• Proactive MD NM, LLC (Proactive MD SONM Santa Fe Health Center)
• Rafal Proban, M.D.
• Tamara Prochorchik
• Christina Procter, LMSW

• Pediatric Dentistry in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Pediatric Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.