Pavel Nyukeyev, LD

Primary specialty

DenturistTaxonomy code 122400000X

License

DN61173296 Issued in WA

Practice address

3916 Main St # 104
Vancouver, WA 98663-1844

Phone

(360) 524-2004

NPI assigned

Apr 29, 2024

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

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.

• Smile More Dentures LLC

  • Denturist
  • Vancouver, WA
  • NPI 1316806243
  NPD Authorized official

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1861248809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 MAIN ST # 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986631844",
            "telephone_number": "360-524-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 MAIN ST # 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986631844",
            "telephone_number": "360-524-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYUKEYEV",
        "first_name": "PAVEL",
        "credential": "LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN61173296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Nymeyer
• Teri J Nyssen, RC
• Allison Nystrom, ARNP
• Eva Nystrom, FNP-BC
• Theron Bradley Nystrom
• Ashleigh Eileen O'Brien, LCSW, LICSW
• Colin O'Brien, MD
• Kimberly Renee O'Brien, OTR/L
• Timothy Patrick O'Brien
• Brenda Louise O'Connor

• Denturist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.