Yelena Jane Chuzhin, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN015187 Issued in GA

Practice address

790 Glenwood Ave SE Ste 210
Atlanta, GA 30316-2024

Phone

(404) 260-4767

Fax

(404) 609-2508

NPI assigned

Jun 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Practice roles

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.

• Glenwood Park Dentistry, PC

  dba Glenwood Dentistry

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1053769265
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1649684796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N QUINCY ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031907",
            "telephone_number": "703-276-1010",
            "fax_number": "703-566-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 GLENWOOD AVE SE STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162024",
            "telephone_number": "404-260-4767",
            "fax_number": "404-609-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUZHIN",
        "first_name": "YELENA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Mundy Churchill, M.S., LPC, NCC
• Danielle P Churchman
• Becca Churchwell, FNP-BC
• Amber Danielle Churn
• Phyllis Churn
• Yvette Cianfaglione
• Louis Nicholas Ciardulli, M.D.
• George M Cibik, M.D.
• Nicole Schmidt Ciborowski, AA
• Taelor Cichanski, PA-C

• Dentist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.