Individual provider Active NPI

Olga A Saniukovich, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fargo, ND
National Provider Identifier
1447819784
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
DN24170 Issued in FL
Practice address
1650 45TH St S Ste 108
Fargo, ND 58103-3247
Phone
(701) 526-4652
Fax
(701) 282-2572
NPI assigned
Jun 11, 2019
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2574 ND
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X DN24170 FL Primary

Addresses

Primary practice location

1650 45TH St S Ste 108
Fargo, ND 58103-3247

Mailing address

3626 E Hamilton Ky
West Palm Beach, FL 33411-6436
Phone (727) 505-3720

Other practice location 1

3300 32nd Ave S Ste 103
Grand Forks, ND 58201-5803
Phone (701) 765-3494

Other practice location 2

440 S State Road 7 Ste 100
Royal Palm Beach, FL 33414-4414
Phone (561) 753-6963

Other practice location 3

9192 Glades Rd Ste B
Boca Raton, FL 33434-3912
Phone (561) 576-9086

Other practice location 4

3333 Northlake Blvd Ste 6
Palm Beach Gardens, FL 33403-1717
Phone (561) 776-9984

Other practice location 5

6169 S Jog Rd Unit A8A9
Lake Worth, FL 33467-6579
Phone (561) 328-2326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250206000657 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002249471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN24170FLMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Krista Johnson DMD PLLC PastSince Jul 22, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1447819784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 E HAMILTON KY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116436",
            "telephone_number": "727-505-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 45TH ST S STE 108",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033247",
            "telephone_number": "701-526-4652",
            "fax_number": "701-282-2572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 32nd Ave S Ste 103",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582015803",
            "country_code": "US",
            "telephone_number": "701-765-3494",
            "fax_number": "701-757-1244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 S State Road 7 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Royal Palm Beach",
            "state": "FL",
            "postal_code": "334144414",
            "country_code": "US",
            "telephone_number": "561-753-6963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9192 Glades Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334343912",
            "country_code": "US",
            "telephone_number": "561-576-9086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Northlake Blvd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334031717",
            "country_code": "US",
            "telephone_number": "561-776-9984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6169 S Jog Rd Unit A8A9",
            "address_purpose": "LOCATION",
            "city": "Lake Worth",
            "state": "FL",
            "postal_code": "334676579",
            "country_code": "US",
            "telephone_number": "561-328-2326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANIUKOVICH",
        "first_name": "OLGA",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ND",
            "license": "2574",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "DN24170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.