Individual provider Active NPI

Yelena Tabak, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1619966736
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
044955 Issued in NY
Practice address
3130 Brighton 6TH St
1D
Brooklyn, NY 11235-6954
Phone
(718) 648-2067
Fax
(718) 648-2167
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 044955 NY Primary

Addresses

Primary practice location

3130 Brighton 6TH St
1D
Brooklyn, NY 11235-6954

Mailing address

3130 Brighton 6TH St
Ste 1D
Brooklyn, NY 11235-6970
Phone (718) 648-2067

Other identifiers 2

IdentifierTypeStateIssuer
D001056 01OtherNYAMERICHOICE
01437585MedicaidNY

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kolotsi NP Family Health PC PastSince Apr 28, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619966736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 BRIGHTON 6TH ST",
            "address_2": "STE 1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356970",
            "telephone_number": "718-648-2067",
            "fax_number": "718-648-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 BRIGHTON 6TH ST",
            "address_2": "1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356954",
            "telephone_number": "718-648-2067",
            "fax_number": "718-648-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABAK",
        "first_name": "YELENA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "044955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "D001056 01",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01437585",
            "state": "NY"
        }
    ],
    "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 Jul 13, 2026; 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.