Yury Geylikman, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

41255 Issued in CA

Practice address

12626 Riverside Dr.,
408
Valley Village, CA 91607-3453

Phone

(323) 656-9111

Fax

(323) 650-9669

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1508932039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR.,",
            "address_2": "408",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073453",
            "telephone_number": "323-656-9111",
            "fax_number": "323-650-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR.,",
            "address_2": "408",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073453",
            "telephone_number": "323-656-9111",
            "fax_number": "323-650-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEYLIKMAN",
        "first_name": "YURY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41255",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "41255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B41255-02",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B41255-01",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B41255-04",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Gantman, PSY.D.
• Lusya Gasparyan
• Gemini Home Health Inc.
• Alexander Illych Gerbakher, DMD
• Svetlana Germashev, OTR/L
• Ramin Ghayoori, M.D.
• Bruno Patrick Giannotta, D.C.
• Soheil Daniel Gideon
• Tanya Kaur Gill, MA
• Shannon Gilliam

• Orthodontics and Dentofacial Orthopedics Dentistry in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.