Dmitriy Itskovich, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12967 Issued in MD

Practice address

481 N Frederick Ave Ste 104
Gaithersburg, MD 20877-2470

Phone

(301) 926-1407

Fax

(301) 926-9035

NPI assigned

Feb 7, 2008

Sex

Male

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 MD

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• RND Dental

  • Dentist
  • Gaithersburg, MD
  • NPI 1811100167
  NPD (past)

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1336327782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 N FREDERICK AVE STE 104",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772470",
            "telephone_number": "301-926-1407",
            "fax_number": "301-926-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 N FREDERICK AVE STE 104",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772470",
            "telephone_number": "301-926-1407",
            "fax_number": "301-926-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITSKOVICH",
        "first_name": "DMITRIY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mubazar Muhammad Ishfaq
• Raisa Islam
• Samsuzzuha M. Tariqul Islam
• Islamic Center of Maryland
• Dana Elaine Isom, LCPC
• Olena Ivanova, CRNP-FAMILY
• Shaylynnkinne Yvonna Ivory, LMSW
• Claressa Nicole Iwukemjika
• Jablessmeh Services Inc
• Jacie Enterprises

• Dentist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.