Active NPI
Oleg A Shvartsur, D.D.S.
- Dentist
- Issaquah, WA
National Provider Identifier
1962799841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60222150
- Practice address
- 5825 221St PL SE
Suite #101
Issaquah, WA 98027-8927 - Phone
- (425) 503-8020
- NPI assigned
- Jun 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60222150 | WA | Primary |
Addresses
Primary practice location
5825 221St PL SE
Suite #101
Issaquah, WA 98027-8927
Mailing address
5825 221St PL SE
Suite #101
Issaquah, WA 98027-8927
Phone (425) 503-8020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE60222150 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oleg a Shvartsur DDS PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Issaquah, WA
- NPI 1407110471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310428800000",
"number": "1962799841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5825 221ST PL SE",
"address_2": "SUITE #101",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278927",
"telephone_number": "425-503-8020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5825 221ST PL SE",
"address_2": "SUITE #101",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278927",
"telephone_number": "425-503-8020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHVARTSUR",
"first_name": "OLEG",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-29",
"last_updated": "2011-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60222150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.