Individual provider Active NPI

Yuliya Kostenko, DMD

  • General Practice Dentistry
  • Lynn, MA
National Provider Identifier
1376837500
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855696 Issued in MA
Practice address
74 Market St
Lynn, MA 01901-1115
Phone
(781) 581-1411
Fax
(781) 581-1433
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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 DN1855696 MA Primary

Addresses

Primary practice location

74 Market St
Lynn, MA 01901-1115

Mailing address

74 Market St
Lynn, MA 01901-1115
Phone (781) 581-1411

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
DN1855696MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr.Kostenko D.M.D. P.C. General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1376837500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 MARKET ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011115",
            "telephone_number": "781-581-1411",
            "fax_number": "781-581-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 MARKET ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011115",
            "telephone_number": "781-581-1411",
            "fax_number": "781-581-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTENKO",
        "first_name": "YULIYA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.