Provider Demographics
NPI:1376851923
Name:KARPTSOV, ELENA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:
Last Name:KARPTSOV
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 OAK ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5012
Mailing Address - Country:US
Mailing Address - Phone:315-269-9234
Mailing Address - Fax:
Practice Address - Street 1:1303 OAK ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5012
Practice Address - Country:US
Practice Address - Phone:315-269-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025840124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist