Active NPI
Victoria Shklovsky, D.D.S.
- General Practice Dentistry
- Denver, CO
National Provider Identifier
1316077407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 048297-1
- Practice address
- 9450 E Mississippi Ave Unit a
Denver, CO 80247-2427 - Phone
- (303) 503-3260
- NPI assigned
- Mar 7, 2007
- Last updated
- Sep 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 048297-1 | NY | Primary |
Addresses
Primary practice location
9450 E Mississippi Ave Unit a
Denver, CO 80247-2427
Mailing address
17011 Lincoln Ave # 561
Parker, CO 80134-3144
Phone (970) 433-9777
Other practice location 1
161 N Park Sq
Fruita, CO 81521-2530
Phone (718) 646-2828
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6199200001 | Other | NY | MEDICARE SUPPLIER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048297-1 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Sleep Wellness LLC | Current | Accepting new patients | |
| Shore Dental Care, P.C. | Past | Accepting new patients |
Locations
161 N Park Sq
Fruita, CO 81521
Phone (970) 433-9777
Organizations & group practices 3
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.
-
- Dentist
- Fruita, CO
- NPI 1578160545
-
- Dentist
- Denver, CO
- NPI 1396159950
-
- Dentist
- Brooklyn, NY
- NPI 1336373489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1316077407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17011 LINCOLN AVE # 561",
"city": "PARKER",
"state": "CO",
"postal_code": "801343144",
"telephone_number": "970-433-9777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9450 E MISSISSIPPI AVE UNIT A",
"city": "DENVER",
"state": "CO",
"postal_code": "802472427",
"telephone_number": "303-503-3260"
}
],
"practiceLocations": [
{
"address_1": "161 N Park Sq",
"address_purpose": "LOCATION",
"city": "Fruita",
"state": "CO",
"postal_code": "815212530",
"country_code": "US",
"telephone_number": "718-646-2828",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHKLOVSKY",
"first_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "048297-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE SUPPLIER",
"identifier": "6199200001",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.