Gy Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

049312 Issued in NY

Legal business name

GY DENTAL PC

Practice address

1419 Foster Ave
Brooklyn, NY 11230-1726

Phone

(718) 421-6300

Fax

(718) 421-6001

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Grigoriy Yusupov, DDS

Title

DDS General Dentist

Phone

(718) 421-6300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790900785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-46 62 DRIVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-421-6300",
            "fax_number": "718-421-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 FOSTER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112301726",
            "telephone_number": "718-421-6300",
            "fax_number": "718-421-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YUSUPOV",
        "authorized_official_first_name": "GRIGORIY",
        "authorized_official_title_or_position": "DDS GENERAL DENTIST",
        "authorized_official_telephone_number": "718-421-6300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02207692",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariya Gvozdeva
• Gadziro Gwekwerere
• Gary A. Gwertzman, M.D.
• Josephine S Gwira, RN
• Rodney Alexander Gwyn, LCSW
• Gy Optometry Care, PC
• Albertina Gyamfi
• Emily Gylleenhaal
• Mahri Gylychmammedova, SN
• Lila Pearl Gyory

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, 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 Aug 22, 2020; 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.