Svetlana Pedenko MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29507 Issued in AZ

Legal business name

SVETLANA PEDENKO MD PC

Practice address

1520 S Dobson Rd
Suite 307
Mesa, AZ 85202-4725

Phone

(480) 874-7014

Fax

(480) 874-7015

NPI assigned

Aug 18, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Svetlana L Pedenko, MD

Title

MD

Phone

(480) 874-7014

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1689129769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 E BROADWAY RD",
            "address_2": "SUITE 205",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821511",
            "telephone_number": "480-874-7014",
            "fax_number": "480-874-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD",
            "address_2": "SUITE 307",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024725",
            "telephone_number": "480-874-7014",
            "fax_number": "480-874-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SVETLANA PEDENKO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "PEDENKO",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "480-874-7014",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "29507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.