Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Vladislav Ivanchenko, OD

Individual provider Optometrist · NPI 1497210009

Vladislav Ivanchenko, OD is an Optometry in Canton, Georgia. Qualified in 2015, 11 years ago. Practices with Leiv M Takle MD PC, a 5-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
11
Licensed in
GA
In the registry since
2019
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

2030 Cumming Hwy Ste 106
Canton, GA 30115-8009
Phone: (678) 493-2220
Fax: (678) 493-4832
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT003096 (GA)

Record details

NPI number1497210009
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedFebruary 7, 2019
Last updated in NPPESJuly 18, 2025
Certification dateJuly 18, 2025
Mailing address2002 Millington Ln, Jacksonville, FL 32246-1386

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Leiv M Takle Md Pc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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