Kazak Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KAZAK DENTAL CORP

Practice address

915 Sir Francis Drake Blvd Ste 1
San Anselmo, CA 94960-1946

Phone

(415) 454-5667

NPI assigned

Feb 12, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Nikit F Kazak, DDS

Title

President

Phone

(415) 652-9916

Specialties & licenses 1

Addresses

Other names 1

• Ross Valley Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nikita Feliksovich Kazak, DDS

  • Dentist
  • San Anselmo, CA
  • NPI 1891272399
  NPD

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644624000000",
    "number": "1841945490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 SIR FRANCIS DRAKE BLVD STE 1",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601946",
            "telephone_number": "415-454-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SIR FRANCIS DRAKE BLVD STE 1",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601946",
            "telephone_number": "415-454-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAZAK DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A",
        "authorized_official_last_name": "KAZAK",
        "authorized_official_first_name": "NIKIT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-652-9916",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ross Valley Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John David Culbertson, MD Inc
• Megan L Jones
• Barbara Theiss Juniper
• Mured Kakar, ABO
• Kathleen McDonough Physical Therapy Associates PC
• Nikita Feliksovich Kazak, DDS
• Heidi Jane Keller, M.S, D.C.
• Cara Jean Kerby, LPCC, LAADC
• Nicholas G Kerry, O.D.
• Bruce Andrew Killen, MFT

• Dental Clinic/Center in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; 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.