Individual provider Active NPI

Victoria Shklovsky, D.D.S.

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1316077407
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048297-1 Issued in NY
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 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

IdentifierTypeStateIssuer
6199200001OtherNYMEDICARE 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

LicenseStateTypeSpecialty
048297-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Sleep Wellness LLC CurrentSince Jun 1, 2021 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.

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.

Verify at the official NPI Registry.