Active NPI
Vlad Kokorin
- General Practice Dentistry
- Huntsville, AL
National Provider Identifier
1477243129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D.007174-C1
- Practice address
- 2801 Memorial Pkwy SW
Huntsville, AL 35801-6519 - Phone
- (256) 529-5179
- NPI assigned
- May 8, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D.007174-C1 | AL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | AL |
Addresses
Primary practice location
2801 Memorial Pkwy SW
Huntsville, AL 35801-6519
Mailing address
2801 Memorial Pkwy SW
Huntsville, AL 35801-6519
Phone (256) 529-5179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D.007174-C1 | AL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686182400000",
"number": "1477243129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 MEMORIAL PKWY SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358016519",
"telephone_number": "256-529-5179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 MEMORIAL PKWY SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358016519",
"telephone_number": "256-529-5179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOKORIN",
"first_name": "VLAD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-08",
"last_updated": "2023-06-08",
"certification_date": "2023-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "D.007174-C1",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.