Paul Peysakhov, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

049224-1 Issued in NY

Practice address

1985 Ocean Ave # 1D
Brooklyn, NY 11230-6872

Phone

(718) 376-1090

Fax

(718) 376-7652

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• RC Dental PC

  • Dental Clinic/Center
  • Brooklyn, NY
  • NPI 1427220342
  NPD (past) Authorized official

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1831170422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 E 5TH ST APT 5G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306915",
            "telephone_number": "718-375-1827",
            "fax_number": "718-376-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 OCEAN AVE # 1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306872",
            "telephone_number": "718-376-1090",
            "fax_number": "718-376-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYSAKHOV",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049224-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02368110",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatyana Pevzner, M.D.
• Vadim Pevzner
• Jacob Peykar
• Nechama Peykar
• Sara Peykar
• Zoya Peysakhov, M.S. CCC-SLP
• Sofya Peysakhova, MS ED
• Christopher Michael Peyser, LCAT
• Boris Peysin, M.D.
• Konstantin Peysin, D.O.

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.