Michael Yehuda Ivry, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0479621 Issued in NY

Practice address

44 S Central Ave Ste 2
Valley Stream, NY 11580

Phone

(516) 561-7788

Fax

(516) 596-7455

NPI assigned

Feb 7, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• South Central Dental Implant PLLC

  • Dentist
  • Valley Stream, NY
  • NPI 1144767773
  NPD (past) Authorized official

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1154509503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 HAWKINS AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551604",
            "telephone_number": "631-585-6880",
            "fax_number": "631-585-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S CENTRAL AVE STE 2",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-561-7788",
            "fax_number": "516-596-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVRY",
        "first_name": "MICHAEL",
        "middle_name": "YEHUDA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0479621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154509503",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Island Musculoskeletal Care MD PC
• Island Surgical Practice PC
• Eytan Israelov, FNP
• Ludmila Israelov
• Ruty Israilov
• J & D Chemists, Inc. (DBA Parkdale Pharmacy)
• J Darbouze OT Services PC
• J. Sklar Computers
• J&S Mental Health Counseling, PLLC
• Jack M. Rubenstein, MD (Center for Diagnostic Consultation)

• Dentist in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.