Active NPI
Olga Gurevich, DDS
- Dentist
- Brooklyn, NY
National Provider Identifier
1720120009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 051355
- Practice address
- 2173 A 68 Street
Brooklyn, NY 11204 - Phone
- (718) 621-0827
- Fax
- (718) 621-0829
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 051355 | NY | Primary |
Addresses
Primary practice location
2173 A 68 Street
Brooklyn, NY 11204
Mailing address
602 Ave T
Apt #4J
Brooklyn, NY 11223
Phone (646) 239-5568
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02569139 | Medicaid | NY |
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 |
|---|---|---|---|
| 051355 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720120009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 AVE T",
"address_2": "APT #4J",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11223",
"telephone_number": "646-239-5568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2173 A 68 STREET",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11204",
"telephone_number": "718-621-0827",
"fax_number": "718-621-0829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUREVICH",
"first_name": "OLGA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "051355",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02569139",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.