Nichole Kostiuk, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40000 Issued in TX

Practice address

9901 Brodie LN Ste 130
Austin, TX 78748-5889

Phone

(737) 203-8538

NPI assigned

Jun 11, 2021

Last updated

May 30, 2024By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Smile Bar Professional Corporation

  • Dental Clinic/Center
  • Austin, TX
  • NPI 1033965009
  NPD Authorized official
• Tru Dentistry Soco PLLC

  dba TRU Dentistry SoCo

  • Dental Clinic/Center
  • Austin, TX
  • NPI 1558299545
  NPD Authorized official

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1407424955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 BRODIE LN STE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787485889",
            "telephone_number": "737-203-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 BRODIE LN STE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787485889",
            "telephone_number": "737-203-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTIUK",
        "first_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Kosobucki
• Molly Digaetano Kosoris, ACNS-BC
• Savannah Marin Kossegi, M.ED, BCBA, LBA
• Alexandr Kostenko Jr., PT, DPT
• Hannah Ruth Koster, LCSW
• Riti Kotamarti, MD
• Sussann Grace Kotara, M.D.
• Kotel Atx
• Kotel Atx PLLC (Heading Health)
• Katelyn Opichka Kothari, MS, RD, LD

• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.