MEDICARE: DR. EMIL KOVETSKI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10829	KY
2	122300000X	Dentist	10829	KY
3	1223P0300X	Periodontics	27187	FL

General Provider Information

NPI Number	:	1740916725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMIL KOVETSKI DMD

Provider Business Mailing Address
First Line	:	2730 WELAUNEE BLVD UNIT 407
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-6052
Country	:	US
Telephone Number	:	954-398-3508
Fax Number	:

Provider Business Practice Location Address
First Line	:	3363 NE 163RD ST STE 803
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-4438
Country	:	US
Telephone Number	:	305-949-4454
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	02/23/2026

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