Individual provider Active NPI

Svetlana Rozvodovskaya, RDH

  • Dental Hygienist
  • Spokane, WA
National Provider Identifier
1720288558
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH00007848 Issued in WA
Practice address
3009 S. Mt Vernon
Spokane, WA 99223
Phone
(509) 534-2666
Fax
(509) 534-1392
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH00007848 WA Primary

Addresses

Primary practice location

3009 S. Mt Vernon
Spokane, WA 99223

Mailing address

3919 N Maple St
Spokane, WA 99205-1349
Phone (509) 444-8888

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

LicenseStateTypeSpecialty
DH00007848WAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Operation Healthy Family CurrentSince Jun 27, 2021 Accepting new patients
David J. Hone PastSince Jun 27, 2021 Accepting new patients

Locations

3009 S Mount Vernon St
Spokane, WA 99223
Phone (509) 534-2666

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1720288558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 N MAPLE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051349",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 S. MT VERNON",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99223",
            "telephone_number": "509-534-2666",
            "fax_number": "509-534-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZVODOVSKAYA",
        "first_name": "SVETLANA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00007848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.