Ilya Yagudayev DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ILYA YAGUDAYEV DDS, PC

Doing business as

Affordable Dental Care

Practice address

517 Pulaski St
Office B
Riverhead, NY 11901-3210

Phone

(516) 860-4176

NPI assigned

Mar 3, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Eduard Yagudayev

Title

Office Manager

Phone

(516) 860-4176

Specialties & licenses 1

Addresses

Other names 1

• Affordable Dental Care Doing business as

Locations

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1093955098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 PULASKI ST",
            "address_2": "OFFICE B",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 PULASKI ST",
            "address_2": "OFFICE B",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013210",
            "telephone_number": "516-860-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILYA YAGUDAYEV DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "YAGUDAYEV",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-860-4176",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Riverhead, NY
• Providers in Riverhead, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.