NPIMap

Organization Active NPI

Oleg a Shvartsur DDS PLLC

  • Dentist
  • Issaquah, WA
National Provider Identifier
1407110471
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60222150 Issued in WA
Legal business name
OLEG A SHVARTSUR DDS PLLC
Practice address
710 NW Juniper St
Suite 101
Issaquah, WA 98027-2717
Phone
(425) 392-4600
Fax
(425) 392-0503
NPI assigned
Jun 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Authorized official

Name
Dr. Oleg A Shvartsur, D.D.S.NPI 1962799841
Title
Owner
Phone
(425) 503-8020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE60222150 WA Primary

Addresses

Primary practice location

710 NW Juniper St
Suite 101
Issaquah, WA 98027-2717

Mailing address

710 NW Juniper St
Suite 101
Issaquah, WA 98027-2717
Phone (425) 392-4600

National Provider Directory

National Provider Directory

Locations

710 NW Juniper St
Ste 101
Issaquah, WA 98027
Phone (425) 382-7170

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1407110471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-4600",
            "fax_number": "425-392-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-4600",
            "fax_number": "425-392-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLEG A SHVARTSUR DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "SHVARTSUR",
        "authorized_official_first_name": "OLEG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-503-8020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60222150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.