Yury Bershadsky, D.D.S.

Individual provider Active NPI General Practice Dentistry · Chatsworth, CA

NPI 1255545976 · NPPES record last updated Nov 20, 2012

Key facts

NPI
1255545976
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
43757 (CA)
Practice address
10108 Topanga Canyon Blvd
Chatsworth, CA 91311-2801
Phone
(818) 709-6713
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
43757CAMDNeonatal/Pediatric Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yury Bershadsky D.D.S. Inc. Past Accepting new patients
Elliot P. Schlang DDS Inc. Past
since Apr 25, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43757 CA Yes

Addresses

Primary practice location

10108 Topanga Canyon Blvd
Chatsworth, CA 91311-2801

Mailing address

10108 Topanga Canyon Blvd
Chatsworth, CA 91311-2801
Phone (818) 709-6713

Other identifiers

IdentifierTypeStateIssuer
B43757-01MedicaidCA

Other providers in Chatsworth, CA

All providers in Chatsworth, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.