Kristopher K Kostenko, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D10835 Issued in OR

Practice address

14201 NE 20TH Ave Ste A101
Vancouver, WA 98686

Phone

(360) 882-0222

NPI assigned

Jul 8, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1801382387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9511 NE HAZEL DELL AVE # B16",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658157",
            "telephone_number": "509-528-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 NE 20TH AVE STE A101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-882-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5880 NE Cornell Rd",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971249075",
            "country_code": "US",
            "telephone_number": "503-615-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTENKO",
        "first_name": "KRISTOPHER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Korn
• Elizabeth Korsikas-Fogg, B.S.
• Chris Kos, PMHNP-BC
• David A Kosa, DDS
• Maria Anna Koscinska, M.D.
• Sarah Kostick
• Julia Kostin, MA, LMHC
• Susan M Kostman, CDP
• Tiffany Kostrba, CDPT
• Svetlana Kotova, MD

• Dentist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.