Emmanuil Ilyayev, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

058141 Issued in NY

Practice address

9819 64TH Ave
4G
Rego Park, NY 11374-2542

Phone

(718) 578-8612

NPI assigned

Aug 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Dr. I Dental PC

  • Dental Clinic/Center
  • Elmhurst, NY
  • NPI 1053819318
  NPD (past) Authorized official

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1679766646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9819 64TH AVE",
            "address_2": "4G",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742542",
            "telephone_number": "718-578-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9819 64TH AVE",
            "address_2": "4G",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742542",
            "telephone_number": "718-578-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYAYEV",
        "first_name": "EMMANUIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11338",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduard Ilyasov
• Mikhail Ilyasov, OTR/L
• Svetlana Ilyasova
• Albert Ilyayev, D.D.S
• Eitan Ilyayev, (PA)
• Daniela Ilyayeva, OTR/L
• Dora Ilyayeva
• Inessa Ilyayeva
• Julia A Ilyayeva
• Stella Ilyayeva, MD

• General Practice Dentistry in Rego Park, NY
• Providers in Rego Park, 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 Mar 7, 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.