COLOMA DENTAL OFFICE OF RUSLAN ZMIEVSCHI, INC Full NPI Record 1184249583
Dentist - General Practice in Lotus, CA

Complete NPI Dataset

The following table represents the complete NPI 1184249583 dataset for Coloma Dental Office Of Ruslan Zmievschi, Inc in 7170 HIGHWAY CA-49,SUITE 3 LOTUS, CA 95651. The data table includes a list of all field names, values and definitions of the complete NPI record. The NPI dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1184249583The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameCOLOMA DENTAL OFFICE OF RUSLAN ZMIEVSCHI, INCThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing AddressPO BOX 944The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameLOTUSThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameCAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code956510944The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address7170 HIGHWAY CA-49,SUITE 3The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOTUSThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code956519565The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.


Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number5306210900The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date6/11/2020The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date7/14/2020The date that a record was last updated or changed.
Authorized Official Last NameZMIEVSCHIThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameRUSLANThe first name of the authorized official.
Authorized Official Middle NameDENTALThe middle name of the authorized official.
Authorized Official Title or PositionOWNERThe title or position of the authorized official.
Authorized Official Telephone Number5306210900The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 11223G0001XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Is Organization SubpartN
Authorized Official Credential TextDDS
Healthcare Provider Taxonomy Group 1193400000X SINGLE SPECIALTY GROUP
NPI Certification Date7/14/2020