Individual provider Active NPI

Yana Kapustina, DDS

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1508229766
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9955 Issued in AZ
Practice address
2641 N 44TH St Ste 101
Phoenix, AZ 85008-1573
Phone
(602) 698-0234
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9955 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2641 N 44TH St Ste 101
Phoenix, AZ 85008-1573

Mailing address

2641 N 44TH St Ste 101
Phoenix, AZ 85008-1573
Phone (917) 696-1497

Other practice location 1

525 E 68th St
New York, NY 10065-4870
Phone (212) 746-5175

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

LicenseStateTypeSpecialty
9955AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1508229766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 N 44TH ST STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850081573",
            "telephone_number": "917-696-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 N 44TH ST STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850081573",
            "telephone_number": "602-698-0234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-5175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPUSTINA",
        "first_name": "YANA",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "9955",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.