Dmitry Karagodsky, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS031011 L Issued in PA

Practice address

11880 Bustleton Ave
Philadelphia, PA 19116-2538

Phone

(215) 969-2015

Fax

(215) 969-2014

NPI assigned

Jun 12, 2007

Sex

Male

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Smile Maker

  • General Practice Dentistry
  • Southampton, PA
  • NPI 1154049047
  NPD Authorized official
• I Smile Lawrenceville PC

  • Dentist
  • Lawrenceville, NJ
  • NPI 1982260964
  NPD Authorized official
• I-Smile Dental PC

  • Dentist
  • Trenton, NJ
  • NPI 1669895199
  NPD (past) Authorized official

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992909261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162538",
            "telephone_number": "215-969-2015",
            "fax_number": "215-969-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11880 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162538",
            "telephone_number": "215-969-2015",
            "fax_number": "215-969-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAGODSKY",
        "first_name": "DMITRY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS031011 L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine M Kapterian, CRNA
• Anneke Plantinga Kapteyn-Zhao, PA-C
• Paromita Kar Haye, LMFT
• Saban Kar
• Stephen Karafelli
• Susan Elizabeth Karakawa, PT
• Giorgos Constantine Karakousis, MD
• Sezen Karakus, MD MPH
• Dean G Karalis, MD
• Stephanie Karalis

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.