Sergey Floryanovich, DDS
Individual provider Active NPI Dentist · Washington, IA
NPI 1386809192 · NPPES record last updated Feb 11, 2019
Key facts
- NPI
- 1386809192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 8563 (IA)
- Practice address
- 1051 W Madison St
Washington, IA 52353-1623 - Phone
- (319) 653-3412
- Fax
- (319) 653-5511
- NPI assigned
- Jul 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8563 | IA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Care by the Square | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8563 | IA | Yes |
Addresses
Primary practice location
1051 W Madison St
Washington, IA 52353-1623
Mailing address
1051 W Madison St
Washington, IA 52353-1623
Phone (319) 653-3412
Other providers in Washington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.