Olesia Kesova, DMD

Individual provider Active NPI General Practice Dentistry · Bay Harbor Islands, FL

NPI 1750155669 · NPPES record last updated Nov 10, 2023

Key facts

NPI
1750155669
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN28651 (FL)
Practice address
1048 Kane Concourse
Bay Harbor Islands, FL 33154-2132
Phone
(305) 615-5722
Fax
(954) 900-1635
NPI assigned
Nov 10, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN28651FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Cosmetic Dentistry Amd General Practice Past
since Nov 12, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN28651 FL Yes

Addresses

Primary practice location

1048 Kane Concourse
Bay Harbor Islands, FL 33154-2132

Mailing address

1818 Hollywood Blvd Apt 906
Hollywood, FL 33020-6857
Phone (754) 284-7974

Other providers in Bay Harbor Islands, FL

All providers in Bay Harbor Islands, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.