Olga Goncharova, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008984 Issued in CT

Practice address

316 Hope St
Family Dental Practice
Stamford, CT 06906-1704

Phone

(203) 353-8532

Fax

(203) 353-8542

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

Yes

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

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family Dental Practice PC

  • General Practice Dentistry
  • Stamford, CT
  • NPI 1376789966
  NPD (past) Authorized official
• Shippan Dental Center

  • General Practice Dentistry
  • Stamford, CT
  • NPI 1063758183
  NPD (past) Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1851446058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 HOPE ST",
            "address_2": "FAMILY DENTAL PRACTICE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069061704",
            "telephone_number": "203-353-8532",
            "fax_number": "203-353-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 HOPE ST",
            "address_2": "FAMILY DENTAL PRACTICE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069061704",
            "telephone_number": "203-353-8532",
            "fax_number": "203-353-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCHAROVA",
        "first_name": "OLGA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie I Goldpin, MD
• Adina Goldstein, PH.D
• Melissa Klein Goldstein, M.D.
• Jonathan Carlton Goldweitz, M.D.
• Efraim Gomez Zapata, MD
• Meryum Gondal, MD
• Amina Yixuan Gong, D.D.S.
• Heejae Gong
• Logan Nora Destiny Gonsalves, MD
• Amanda Gonzalez-Bunster

• General Practice Dentistry in Stamford, CT
• Providers in Stamford, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.

Verify at the official NPI Registry.