Gaiana Isakov, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

058690 Issued in NY

Practice address

590 Nicolls Rd
Deer Park, NY 11729-3217

Phone

(631) 477-6777

Fax

(631) 477-6477

NPI assigned

May 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Gaiana Bagumian Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1235517061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MAJESTIC DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117464857",
            "telephone_number": "347-879-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 NICOLLS RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117293217",
            "telephone_number": "631-477-6777",
            "fax_number": "631-477-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAKOV",
        "first_name": "GAIANA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIANA",
            "last_name": "BAGUMIAN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Dentistry in Deer Park, NY
• Providers in Deer Park, 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 Jan 29, 2020; 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.