Active NPI
Olga A Saniukovich, DMD
- Oral & Maxillofacial Surgery (D.M.D.)
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- DN24170
- 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, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250206000657 | IN | Order and Referring Only - Oral Surgery | 6002249471 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN24170 | FL | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Krista Johnson DMD PLLC | 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, 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
- Sanford Medical Center Fargo (Sanford Children's Southwest Clinic)
- Sanford Medical Center Fargo (Sanford Health Occupational Medicine Clinic)
- Sanford Medical Center Fargo (Sanford Professional Building)
- Sanger Inc (Medical Pharmacy-West)
- Heidi Sanger, MSW, LCSW, LISW
- Talitha M. Sannes-Venhuizen, M.D.
- Jennifer Sannes
- Kathleen Sannes
- Ryan Paul Sannes
- Trisha Leigh Sannes
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.