Maryna Kozyryev DDS Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MARYNA KOZYRYEV DDS INC

Practice address

5460 Sunrise Blvd Ste 5
Citrus Heights, CA 95610-7851

Phone

(916) 534-7178

Fax

(916) 534-7460

NPI assigned

Aug 23, 2020

Organization subpart

No

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

Authorized official

Name

Maryna Kozyryev, DDSNPI 1184120487

Title

President

Phone

(916) 534-7178

Specialties & licenses 1

Addresses

Other names 1

• Nova Dental Practice of Maryna Kozyryev DDS Inc Doing business as

Locations

Practitioners 1

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

• Maryna Kozyryev

  • Dentist
  • Auburn, CA
  • NPI 1184120487
  NPD Authorized official

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

{
    "created_epoch": "1598140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1447862123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 SUNRISE BLVD STE 5",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107851",
            "telephone_number": "916-534-7178",
            "fax_number": "916-534-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 SUNRISE BLVD STE 5",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107851",
            "telephone_number": "916-534-7178",
            "fax_number": "916-534-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYNA KOZYRYEV DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-23",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "KOZYRYEV",
        "authorized_official_first_name": "MARYNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-534-7178",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nova Dental Practice of Maryna Kozyryev DDS Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Priscilla Hodge Masten
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• Sarah Matar Abouel Joud

• Dental Clinic/Center in Citrus Heights, CA
• Providers in Citrus Heights, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.