Individual provider Active NPI

Ekaterina N Pollard, D.D.S.

  • General Practice Dentistry
  • Scottsdale, AZ
National Provider Identifier
1639361306
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5808 Issued in AZ
Practice address
9332 E Wood Dr
Scottsdale, AZ 85260-7407
Phone
(602) 308-9391
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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 D5808 AZ Primary

Addresses

Primary practice location

9332 E Wood Dr
Scottsdale, AZ 85260-7407

Mailing address

9332 E Wood Dr
Scottsdale, AZ 85260-7407
Phone (602) 308-9391

Other names 1

  • Dr. Ekaterina N Goncharova Former name

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
D5808AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1639361306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9332 E WOOD DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607407",
            "telephone_number": "602-308-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 E WOOD DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607407",
            "telephone_number": "602-308-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "EKATERINA",
        "middle_name": "N",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EKATERINA",
            "last_name": "GONCHAROVA",
            "middle_name": "N",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.