Individual provider Active NPI

Lana Shmurakov, DDS

  • Dentist
  • San Jose, CA
National Provider Identifier
1326234410
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56335 Issued in CA
Practice address
3535 Ross Ave Ste 304
San Jose, CA 95124-3038
Phone
(408) 265-4064
NPI assigned
Sep 21, 2007
Last updated
Sep 21, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56335 CA Primary

Addresses

Primary practice location

3535 Ross Ave Ste 304
San Jose, CA 95124-3038

Mailing address

13622 Addison St
Sherman Oaks, CA 91423-1412

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
56335CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Eugenia Kutsenko 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, 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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1326234410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13622 ADDISON ST",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 ROSS AVE STE 304",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243038",
            "telephone_number": "408-265-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHMURAKOV",
        "first_name": "LANA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.