Mark Kolchansky, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

46082 Issued in CA

Practice address

665 E Los Angeles Ave Ste D
Simi Valley, CA 93065-1853

Phone

(805) 577-8333

NPI assigned

Dec 22, 2006

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkolchansky@direct.westerndental.com

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.

• Kolchansky Dental Corporation

  • General Practice Dentistry
  • Simi Valley, CA
  • NPI 1538295126
  NPD Authorized official

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1972667863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 E LOS ANGELES AVE",
            "address_2": "STE. D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651849",
            "telephone_number": "805-577-8333",
            "fax_number": "805-299-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 E LOS ANGELES AVE STE D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651853",
            "telephone_number": "805-577-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLCHANSKY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Knight, D.C.
• Robert Knipper
• Jennifer Knox, CERTIFIED HAIR LOSS
• John Jung Gill Koh, MD
• Kolchansky Dental Corporation
• Kenneth Eugene Kolz, D.D.S.
• Howard Ronald Kopel, DDS
• Beverley Kornder, M.D.
• Tessa Margaret Koziol
• Dana Ellen Kramer, R.N.

• Dentist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.