Oleksandr Fedorenko, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1858714 Issued in MA

Practice address

366 Salem St
Medford, MA 02155-3307

Phone

(781) 395-0300

NPI assigned

Jul 21, 2020

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

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.

• Metro Dental

  • Dentist
  • Lexington, MA
  • NPI 1194660290
  NPD Authorized official
• First Dental, PC

  • Dental Clinic/Center
  • Medford, MA
  • NPI 1801074000
  NPD (past)

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1912515313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 E BROOKLINE ST APT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182357",
            "telephone_number": "860-752-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SALEM ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553307",
            "telephone_number": "781-395-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 E Brookline St Apt 4",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182357",
            "country_code": "US",
            "telephone_number": "860-752-9138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDORENKO",
        "first_name": "OLEKSANDR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Marie Farahm, M.ED.,CCC-SLP
• Lauren Farenga
• FBBB, Inc.
• Amy Maher Feck
• Camryn Fedeli
• Paul J Feiss, M.D.
• George M. Feltin, MD
• Elise Fengler
• Robert Fera, LMHC
• Amir Fereidouni, D.M.D., C.A.G.S.

• General Practice Dentistry in Medford, MA
• Providers in Medford, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.