Active NPI
Sviatoslav Kryschuk, D.D.S.
- General Practice Dentistry
- Lincoln, RI
National Provider Identifier
1740612928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN03192
- Practice address
- 12 Breakneck Hill Rd
Lincoln, RI 02865-3909 - Phone
- (401) 726-6160
- NPI assigned
- Jul 30, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN03192 | RI | Primary |
Addresses
Primary practice location
12 Breakneck Hill Rd
Lincoln, RI 02865-3909
Mailing address
8 Powder Mill LN
Greenville, RI 02828-2407
Phone (401) 232-0862
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150612001664 | RI | Order and Referring Only - Oral Surgery | 6800107145 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN03192 | RI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375142400000",
"number": "1740612928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 POWDER MILL LN",
"city": "GREENVILLE",
"state": "RI",
"postal_code": "028282407",
"telephone_number": "401-232-0862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 BREAKNECK HILL RD",
"city": "LINCOLN",
"state": "RI",
"postal_code": "028653909",
"telephone_number": "401-726-6160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRYSCHUK",
"first_name": "SVIATOSLAV",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-30",
"last_updated": "2013-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "RI",
"license": "DEN03192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.