Individual provider Active NPI

Olga Prokopets, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1477636231
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4846 Issued in AZ
Practice address
2401 W Glendale Ave.
Suite 202
Phoenix, AZ 85021
Phone
(602) 249-4404
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4846 AZ Primary

Addresses

Primary practice location

2401 W Glendale Ave.
Suite 202
Phoenix, AZ 85021

Mailing address

2401 W Glendale Ave.
Suite 202
Phoenix, AZ 85021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161222000996 AZ Order and Referring Only - DentistPractitioner - Dentist 6305127788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Olga Prokopets, D.D.S. P.C. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477636231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W GLENDALE AVE.",
            "address_2": "SUITE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W GLENDALE AVE.",
            "address_2": "SUITE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85021",
            "telephone_number": "602-249-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOPETS",
        "first_name": "OLGA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.