Individual provider Active NPI

Tatyana Furman, DMD

  • General Practice Dentistry
  • Radcliff, KY
National Provider Identifier
1689869398
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8518 Issued in KY
Practice address
309 N Wilson Rd
Radcliff, KY 40160
Phone
(270) 352-4343
Fax
(270) 352-2323
NPI assigned
Sep 6, 2007
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012060A IN
Dentist 122300000X 8518 KY
General Practice Dentistry 1223G0001X 8518 KY Primary

Addresses

Primary practice location

309 N Wilson Rd
Radcliff, KY 40160

Mailing address

309 N Wilson Rd
Radcliff, KY 40160
Phone (270) 352-4343

Other names 1

  • Dr. Tatyana Bulkanova Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20160531001688 KY Order and Referring Only - DentistPractitioner - Dentist 6709176902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012060AINMDDentist
8518KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Errol Deveaux & Associates Family Dentistry, PSC Dentist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TATYANA",
            "last_name": "BULKANOVA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Radcliff, KY

Sources for this page

Verify at the official NPI Registry.