Individual provider Active NPI

Tiffany A Kravchenko, DMD

  • General Practice Dentistry
  • North Palm Beach, FL
National Provider Identifier
1912366766
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN21462 Issued in FL
Practice address
1212 US 1 Ste B
North Palm Beach, FL 33408-3536
Phone
(561) 898-0440
NPI assigned
Feb 22, 2016
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 DN21462 FL Primary

Addresses

Primary practice location

1212 US 1 Ste B
North Palm Beach, FL 33408-3536

Mailing address

1212 US 1 Ste B
North Palm Beach, FL 33408-3536
Phone (561) 898-0440

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170906002373 CT Order and Referring Only - DentistPractitioner - Dentist 4183997547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11797CTMDPsychoanalyst
DN21462FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1912366766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 US 1 STE B",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083536",
            "telephone_number": "561-898-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 US 1 STE B",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083536",
            "telephone_number": "561-898-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVCHENKO",
        "first_name": "TIFFANY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN21462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.