Active NPI
Anastasia Borisova Petkova, DDS
- Dentist
- Pittsburgh, PA
National Provider Identifier
1679790687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN9345
- Practice address
- Dental Anesthesiology
3501 Terrace 8FR, G-89 Salk Hall Annex
Pittsburgh, PA 15261 - Phone
- (303) 495-2535
- Fax
- (303) 327-7229
- NPI assigned
- Apr 19, 2007
- Last updated
- Mar 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9345 | CO | |
| Dentist | 122300000X | DEN9345 | CO | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | PA |
Addresses
Primary practice location
Dental Anesthesiology
3501 Terrace 8FR, G-89 Salk Hall Annex
Pittsburgh, PA 15261
Mailing address
3600 Forbes Avenue, Forbes Tower-Plaza Level Suite 140
Pittsburgh, PA 15213
Phone (303) 495-2535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00872733 | Medicaid | CO |
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 |
|---|---|---|---|
| DEN9345 | CO | MD | Dentist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Denver, CO
- NPI 1972819415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1679790687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 FORBES AVENUE, FORBES TOWER-PLAZA LEVEL SUITE 140",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "15213",
"telephone_number": "303-495-2535",
"fax_number": "303-327-7229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DENTAL ANESTHESIOLOGY",
"address_2": "3501 TERRACE 8FR, G-89 SALK HALL ANNEX",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "15261",
"telephone_number": "303-495-2535",
"fax_number": "303-327-7229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETKOVA",
"first_name": "ANASTASIA",
"middle_name": "BORISOVA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2024-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "9345",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN9345",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00872733",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.