NPIMap

Organization Active NPI

Dr.Kostenko D.M.D. P.C.

Doing business as Ace Dental Ass.

  • General Practice Dentistry
  • Lynn, MA
National Provider Identifier
1417127671
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19585 Issued in MA
Legal business name
DR.KOSTENKO D.M.D. P.C.
Doing business as
Ace Dental Ass.
Practice address
74 Market St
Lynn, MA 01901-1115
Phone
(781) 581-1411
Fax
(781) 581-1433
NPI assigned
Mar 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. Valeriy M Kostenko, D.M.D.NPI 1104969583
Title
Dentist
Phone
(781) 581-1411

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19585 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

Other names 1

  • Ace Dental Ass. Doing business as

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1417127671",
    "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": {
        "organization_name": "DR.KOSTENKO D.M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "KOSTENKO",
        "authorized_official_first_name": "VALERIY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "781-581-1411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ace Dental Ass.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 4, 2008; 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.