Stanislav Kovtun, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1856247 Issued in MA

Practice address

185 Harvard St
Brookline, MA 02446-5013

Phone

(617) 274-8494

NPI assigned

May 23, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Stanislav Kovtun DMD, PC

  • Dentist
  • Brookline, MA
  • NPI 1902931686
  NPD Authorized official
• Stanislav Kovtun, DMD PC

  • General Practice Dentistry
  • Brookline, MA
  • NPI 1922462100
  NPD Authorized official
• Masi Dental Group PC

  • Dental Clinic/Center
  • Watertown, MA
  • NPI 1992246458
  NPD (past) Authorized official

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1699112151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SHUMAN CIR",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024592767",
            "telephone_number": "781-264-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465013",
            "telephone_number": "617-274-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVTUN",
        "first_name": "STANISLAV",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fotini Kostogiannis, OD
• Jeffrey E Kotkin, DMD
• Ronni Sachs Kotler, LICSW
• Kousa Psychological Services LLC
• Rimma Kovalcik, PSY.D.
• Christine Elizabeth Kowalcky, PSY.D.
• Regina Koziyevskaya, M.D.
• Kramer Physical Therapy Associates Inc
• Karin Kramer, LIC. AC.
• Linda M Kramer, LICSW

• General Practice Dentistry in Brookline, MA
• Providers in Brookline, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.