Olivia Prehodka

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11291 Issued in KY

Practice address

9031 US Highway 42 Ste a
Union, KY 41091-7196

Phone

(859) 403-3382

NPI assigned

Apr 5, 2021

Last updated

Apr 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• John C Nosti Dental Corporation

  dba La Costa Dentistry and Orthodontics

  • General Practice Dentistry
  • Carlsbad, CA
  • NPI 1366847782
  NPD (past)

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1326627670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9031 US HIGHWAY 42 STE A",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410917196",
            "telephone_number": "859-403-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREHODKA",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared J Patton, PA-C
• Brittany Pauly, PHARMD
• Charle Peck, LCSW
• Timothy Warren Peterson, PA-C
• Powerback Rehabilitation LLC (Powerback Rehabilitation)
• Melonie C Proctor, DO
• Joann Puckett, RN
• Amanda Leigh Race, APRN
• Michelle Raleigh, NP
• Rehab on the Road, PSC

• General Practice Dentistry in Union, KY
• Providers in Union, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.