Individual provider Active NPI

Tatyana V Voloshchenko, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1790090660
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50055179 Issued in NY
Practice address
230 E 30TH St
Apt 15 D
New York, NY 10016-8236
Phone
(502) 836-3603
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 50055179 NY Primary

Addresses

Primary practice location

230 E 30TH St
Apt 15 D
New York, NY 10016-8236

Mailing address

230 E 30TH St
Apt 15 D
New York, NY 10016-8236
Phone (502) 836-3603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160315000060 PA Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Other (Physician) 7012213275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50055179NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1790090660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 30TH ST",
            "address_2": "APT 15 D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168236",
            "telephone_number": "502-836-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 30TH ST",
            "address_2": "APT 15 D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168236",
            "telephone_number": "502-836-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLOSHCHENKO",
        "first_name": "TATYANA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50055179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.