Individual provider Active NPI

Yuriy Normatov, DDS

  • Dentist
  • Forest Hills, NY
National Provider Identifier
1841684933
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0588101 Issued in NY
Practice address
10840 66TH Ave
Forest Hills, NY 11375-2242
Phone
(917) 656-1545
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 011534 CT
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 0588101 NY Primary

Addresses

Primary practice location

10840 66TH Ave
Forest Hills, NY 11375-2242

Mailing address

10840 66TH Ave
Forest Hills, NY 11375-2242
Phone (917) 656-1545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
011534CTMDDentist
0588101NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yn and Am Dental Services CurrentSince Apr 6, 2021 Accepting new patients

Locations

1670 Old Country Rd
Ste 215
Plainview, NY 11803
Phone (516) 753-1776

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.

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1841684933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10840 66TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752242",
            "telephone_number": "917-656-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10840 66TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752242",
            "telephone_number": "917-656-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMATOV",
        "first_name": "YURIY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "011534",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0588101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.