MEDICARE: OLGA LOSEVA DDS

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	039766 1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891983466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGA LOSEVA DDS

Provider Business Mailing Address
First Line	:	30 W 61 ST
Second Line	:	APT 15A
City	:	BROOKLYN
State	:	NY
Zip	:	11219
Country	:	US
Telephone Number	:	718-854-6173
Fax Number	:

Provider Business Practice Location Address
First Line	:	4417 13TH
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214
Country	:	US
Telephone Number	:	718-854-6173
Fax Number	:

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	10/09/2007

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Directions to “ OLGA LOSEVA DDS” Practice Location

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