NPIMap

Organization Active NPI

Dr. Yury B. Geylikman, a Professional Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lancaster, CA
National Provider Identifier
1861682759
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
41255 Issued in CA
Legal business name
DR. YURY B. GEYLIKMAN, A PROFESSIONAL DENTAL CORPORATION
Practice address
1745 W Avenue K
Suite C
Lancaster, CA 93534-6501
Phone
(323) 656-9111
Fax
(323) 650-9669
NPI assigned
Jul 27, 2007
Last updated
Jan 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Dr. Yury B. Geylikman, DMD, PHDNPI 1508932039
Title
Ceo
Phone
(323) 656-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 41255 CA Primary

Addresses

Primary practice location

1745 W Avenue K
Suite C
Lancaster, CA 93534-6501

Mailing address

3940 Laurel Canyon Blvd
#388
Studio City, CA 91604-3709
Phone (323) 656-9111

Other identifiers 1

IdentifierTypeStateIssuer
B41255-01OtherCADENTICAL

National Provider Directory

National Provider Directory
Tax ID family
Dr Yury B Geylikman a Professional Dental Corporation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1861682759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 LAUREL CANYON BLVD",
            "address_2": "#388",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916043709",
            "telephone_number": "323-656-9111",
            "fax_number": "323-650-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W AVENUE K",
            "address_2": "SUITE C",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346501",
            "telephone_number": "323-656-9111",
            "fax_number": "323-650-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. YURY B. GEYLIKMAN, A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "GEYLIKMAN",
        "authorized_official_first_name": "YURY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-656-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, PHD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "41255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B41255-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.