Individual provider Active NPI

Lyubomyr Y Boryslavskyy, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1457684052
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054508 Issued in NY
Practice address
2333 65TH St
Brooklyn, NY 11204-4045
Phone
(847) 452-4138
NPI assigned
Sep 14, 2009
Last updated
Sep 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 054508 NY Primary

Addresses

Primary practice location

2333 65TH St
Brooklyn, NY 11204-4045

Mailing address

2333 65TH St
Brooklyn, NY 11204-4045
Phone (847) 452-4138

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1457684052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 65TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044045",
            "telephone_number": "847-452-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 65TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044045",
            "telephone_number": "847-452-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORYSLAVSKYY",
        "first_name": "LYUBOMYR",
        "middle_name": "Y",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.