Grigoriy Yusupov, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

220102207500 Issued in NJ

Practice address

65 Jefferson Avenue
Elizabeth, NJ 07201

Phone

(908) 527-8688

Fax

(908) 527-9399

NPI assigned

Jun 20, 2008

Last updated

May 1, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dentist

Education

New York University College of Dentistry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fusion Dental, P.C.Group PAC ID 4587997317, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fusion Dental, P.C.

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1073076980
  Medicare reassignment Care Compare group NPD
• Advanced Dental Care P.C

  • Dentist
  • Newark, NJ
  • NPI 1447534755
  Medicare reassignment NPD
• All Quality Dental LLP

  • General Practice Dentistry
  • Elizabeth, NJ
  • NPI 1578788576
  Authorized official Same address or phone
• All Quality Dental LLP

  • Dentist
  • Elizabeth, NJ
  • NPI 1952511651
  Authorized official Same address or phone

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cooperman Barnabas Medical Center Inc

  • General Acute Care Hospital
  • Livingston, NJ
  • NPI 1396857488
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1023279254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JEFFERSON AVENUE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07201",
            "telephone_number": "908-527-8688",
            "fax_number": "908-527-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JEFFERSON AVENUE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07201",
            "telephone_number": "908-527-8688",
            "fax_number": "908-527-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "GRIGORIY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "220102207500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9069909",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eunice Asiedu Yeboah, CNM
• Eric Yeh
• Yorman Counseling Center
• Donna Young, MD
• Gregory Yucht, LSW
• Chana Shira Zablocki, M.D.
• Michael R Zaboski, M.D.
• Rikki Ashlee Zahler, LCSW
• Sana Zaidi, M.D.
• Alexandr Zaitsev, MD

• Dentist in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.