Tatyana Furman, DMD

Key facts

NPI

1689869398

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

8518 (KY)

Practice address

309 N Wilson Rd
Radcliff, KY 40160

Phone

(270) 352-4343

Fax

(270) 352-2323

NPI assigned

Sep 6, 2007

Sex

Female

Sole proprietor

No

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.

• Dr. Errol Deveaux & Associates Family Dentistry, PSC Dentist · Radcliff, KY · NPI 1043483100
  NPD (past) DENTIST

Medicare participation

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

Other names

• Dr. Tatyana Bulkanova Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 20, 2021.

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1689869398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 N WILSON RD",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "40160",
            "telephone_number": "270-352-4343",
            "fax_number": "270-352-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N WILSON RD",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "40160",
            "telephone_number": "270-352-4343",
            "fax_number": "270-352-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURMAN",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012060A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8518",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689869398",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689869398",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TATYANA",
            "last_name": "BULKANOVA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Radcliff, KY · General Practice Dentistry in Kentucky