Individual provider Active NPI

Eugene Khaylomsky

  • Dentist
  • Blasdell, NY
National Provider Identifier
1285989624
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056083 Issued in NY
Practice address
3860 McKinley Pkwy Ste 200
Blasdell, NY 14219-2983
Phone
(716) 649-1307
NPI assigned
Jul 23, 2012
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 056083 NY Primary

Addresses

Primary practice location

3860 McKinley Pkwy Ste 200
Blasdell, NY 14219-2983

Mailing address

3860 McKinley Pkwy Ste 200
Blasdell, NY 14219-2983
Phone (716) 649-1307

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160225001529 NY Order and Referring Only - DentistPractitioner - Dentist 3476858648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056083NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Dental Group,PC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1285989624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 MCKINLEY PKWY STE 200",
            "city": "BLASDELL",
            "state": "NY",
            "postal_code": "142192983",
            "telephone_number": "716-649-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 MCKINLEY PKWY STE 200",
            "city": "BLASDELL",
            "state": "NY",
            "postal_code": "142192983",
            "telephone_number": "716-649-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAYLOMSKY",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blasdell, NY

Sources for this page

Verify at the official NPI Registry.