Advanced Implant and Oral Surgery P.C.

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

052623 Issued in NY

Legal business name

ADVANCED IMPLANT AND ORAL SURGERY P.C.

Practice address

17 Walt Whitman Rd Ste 3
Huntington Station, NY 11746-3610

Phone

(631) 923-1101

NPI assigned

Aug 26, 2011

Organization subpart

No

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

Authorized official

Name

Yuriy Yusupov, DDS

Title

President

Phone

(631) 923-1101

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1699055285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WALT WHITMAN RD STE 3",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WALT WHITMAN RD STE 3",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463610",
            "telephone_number": "631-923-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED IMPLANT AND ORAL SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "YUSUPOV",
        "authorized_official_first_name": "YURIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-923-1101",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "052623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lynn Abbey, OTA
• Jean Carlos Abreu, PA
• Nana Acheampong, R.N, AGNP-C
• Katiusca A Acosta, MD
• Adaptive Personal Touch Physical Therapy PC
• Diana Rossina Aguayo, MS SLP
• Francine Ann Ahearn, LCSW-R, CASAC
• Abu Ahmed, MD
• Taranjeet Ahuja, DO
• Ak Vision LTD.

• Oral and Maxillofacial Surgery Clinic/Center in Huntington Station, NY
• Providers in Huntington Station, NY by specialty
• Oral and Maxillofacial Surgery Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.