Individual provider Active NPI

Olga I Knysh, DDS

  • Dentist
  • Rocklin, CA
National Provider Identifier
1649098617
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
110823 Issued in CA
Practice address
6500 Lonetree Blvd
Rocklin, CA 95765-5874
Phone
(916) 999-0044
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 110823 CA Primary

Addresses

Primary practice location

6500 Lonetree Blvd
Rocklin, CA 95765-5874

Mailing address

4821 Chippendale Dr
Sacramneto, CA 95841
Phone (612) 352-0711

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
110823CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1649098617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 CHIPPENDALE DR",
            "city": "SACRAMNETO",
            "state": "CA",
            "postal_code": "95841",
            "telephone_number": "612-352-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 LONETREE BLVD",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655874",
            "telephone_number": "916-999-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNYSH",
        "first_name": "OLGA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "110823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.