Individual provider Active NPI

Olexandra Ovsiy

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1528595907
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23229 Issued in FL
Practice address
751 Oak St Ste 601
Jacksonville, FL 32204-3373
Phone
(904) 354-4031
NPI assigned
May 17, 2017
Last updated
Mar 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 060060 NY
Dentist 122300000X DN23229 FL Primary
General Practice Dentistry 1223G0001X 060060 NY
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

751 Oak St Ste 601
Jacksonville, FL 32204-3373

Mailing address

751 Oak St Ste 601
Jacksonville, FL 32204-3373
Phone (646) 404-4309

Other practice location 1

2610 Sims Cove Ln
Jacksonville, FL 32223-7118
Phone (646) 404-4309

Other identifiers 1

IdentifierTypeStateIssuer
1528595807MedicaidNY

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
DN23229FLMDDentist
060060NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1528595907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 OAK ST STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043373",
            "telephone_number": "646-404-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 OAK ST STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043373",
            "telephone_number": "904-354-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2610 Sims Cove Ln",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322237118",
            "country_code": "US",
            "telephone_number": "646-404-4309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OVSIY",
        "first_name": "OLEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060060",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23229",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060060",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528595807",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.