Oleg Lyalin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

045561 Issued in NY

Practice address

807A Utica Ave
Brooklyn, NY 11203-3410

Phone

(718) 922-0237

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1639168768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807A UTICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033410",
            "telephone_number": "718-922-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807A UTICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033410",
            "telephone_number": "718-922-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYALIN",
        "first_name": "OLEG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "105879",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01505637",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nevin Ly
• Phuoc Ly, DC
• Vanthanh Ly, M.D.
• Tatyana Lyakh
• Boris Lyakhovetsky, DDS
• Stacy Lyamets
• Michelle Renee Lyde, RPA-C
• May-Wen Jillian Lye
• Charmaine Lyiscott
• Corinne Caridad Lykins, PSY.D.

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.