Active NPI
Kayla Sovak, DMD
- General Practice Dentistry
- Grand Forks, ND
National Provider Identifier
1609393990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2315
- Practice address
- 1101 S Columbia Rd Ste B
Grand Forks, ND 58201-4055 - Phone
- (701) 795-1101
- NPI assigned
- Aug 28, 2017
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2315 | ND | Primary |
Addresses
Primary practice location
1101 S Columbia Rd Ste B
Grand Forks, ND 58201-4055
Mailing address
1101 S Columbia Rd Ste B
Grand Forks, ND 58201-4055
Phone (701) 795-1101
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 |
|---|---|---|---|
| 2315 | ND | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1609393990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 S COLUMBIA RD STE B",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014055",
"telephone_number": "701-795-1101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 S COLUMBIA RD STE B",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014055",
"telephone_number": "701-795-1101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOVAK",
"first_name": "KAYLA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ND",
"license": "2315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.