Organization Active NPI

Yelena V. Gutnichenko, DMD, P.C.

  • Endodontics
  • Waltham, MA
National Provider Identifier
1669516993
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
YELENA V. GUTNICHENKO, DMD, P.C.
Practice address
52 Elm St
Waltham, MA 02453-5317
Phone
(781) 899-9530
Fax
(781) 736-0977
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Yelena V Gutnichenko, D.M.D.
Title
President
Phone
(781) 899-9530

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X

Addresses

Primary practice location

52 Elm St
Waltham, MA 02453-5317

Mailing address

52 Elm St
Waltham, MA 02453-5317
Phone (781) 899-9530

Other identifiers 1

IdentifierTypeStateIssuer
9732811MedicaidMA

Other names 1

  • Elm Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1669516993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 ELM ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535317",
            "telephone_number": "781-899-9530",
            "fax_number": "781-736-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 ELM ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535317",
            "telephone_number": "781-899-9530",
            "fax_number": "781-736-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YELENA V. GUTNICHENKO, DMD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GUTNICHENKO",
        "authorized_official_first_name": "YELENA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-899-9530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9732811",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elm Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.