Gueorgui Ivanov, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21093 Issued in MA

Practice address

226 Essex St
Salem, MA 01970-3705

Phone

(978) 744-2480

Fax

(978) 744-2918

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Mass Bay Dental PC

  • Dentist
  • Salem, MA
  • NPI 1518253822
  NPD (past) Authorized official

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1104922137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 ESSEX ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703705",
            "telephone_number": "978-744-2480",
            "fax_number": "978-744-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 ESSEX ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703705",
            "telephone_number": "978-744-2480",
            "fax_number": "978-744-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "GUEORGUI",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Christine Invernizzi
• Sohah N Iqbal, MD
• Anu Isaac, DMD
• Odette Ezzat Eid Iskandar, MD
• Cheryl Iudice
• Gina Marie Izbicki, R.D, L.D.N
• Cheryl Lee Izen, APRN,PC,BC
• J & E Wellness LLC
• Ali Jabari, M.D.
• Katheryn Jablonski

• General Practice Dentistry in Salem, MA
• Providers in Salem, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; 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.

Verify at the official NPI Registry.