Lev Yusupov, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50 057503 Issued in NY

Practice address

1185 Northern Blvd
Dental Care of Manhasset
Manhasset, NY 11030-3017

Phone

(516) 441-5142

Fax

(516) 441-5146

NPI assigned

Jul 7, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lyusupov563234@nychhc.direct-ci.com

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.

• Dental Care of Manhasset, P.C.

  • Dental Clinic/Center
  • Manhasset, NY
  • NPI 1225406101
  NPD (past) Authorized official
• Lourdes Dental

  • Dentist
  • Manhasset, NY
  • NPI 1740541358

  General Practice

  NPD (past)
• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1174939557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 NORTHERN BLVD",
            "address_2": "DENTAL CARE OF MANHASSET, P.C.",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303017",
            "telephone_number": "516-441-5142",
            "fax_number": "516-441-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 NORTHERN BLVD",
            "address_2": "DENTAL CARE OF MANHASSET",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303017",
            "telephone_number": "516-441-5142",
            "fax_number": "516-441-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "LEV",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50 057503",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yue K Chiu MD PC
• Anar Yukhayev, M.D.
• Philip Sungho Yune, MD, PHD
• Lily L. Yung, M.D.
• Christina Marie Yusko, FNP-BC
• Jessy Koshy Zachariah, NP
• Sharon Anna Zachariah, MD
• Hiba Zafar, MD
• Jamie Madison Zaffos, DDS
• Roy Lewis Zagon, DPM

• General Practice Dentistry in Manhasset, NY
• Providers in Manhasset, 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 Oct 19, 2015; 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.