Active NPI
Julia Niyazova
- Dentist
- Bronx, NY
National Provider Identifier
1104225309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0574941
- Practice address
- 910 E 172ND St
Bronx, NY 10460-5802 - Phone
- (347) 767-2200
- NPI assigned
- Aug 14, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0574941 | NY | Primary |
Addresses
Primary practice location
910 E 172ND St
Bronx, NY 10460-5802
Mailing address
910 E 172ND St
Bronx, NY 10460-5802
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160609000823 | NY | Order and Referring Only - Dentist | 6608166228 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0574941 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416182400000",
"number": "1104225309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 E 172ND ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104605802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 E 172ND ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104605802",
"telephone_number": "347-767-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIYAZOVA",
"first_name": "JULIA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2014-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0574941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.