Peter Mychajliw, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

040877 Issued in NY

Practice address

3 Richards Rd
Port Washington, NY 11050-3824

Phone

(516) 659-1333

NPI assigned

Dec 26, 2006

Last updated

Jan 22, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1912062431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 RICHARDS RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RICHARDS RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503824",
            "telephone_number": "516-659-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYCHAJLIW",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiran Sara Moore
• Hillary Morales, MS CCC-SLP
• Febrian Quratulain Moten, PSYD
• Lena Tung Munter, PA
• Ronald Murphy, PH.D.
• Nassau Pathology PC
• Nicole Natelson, LMSW
• Linda Nazryan, LCSW
• Benjamin T. Neren, D.D.S.
• Barbara Neuman, CSW

• General Practice Dentistry in Port Washington, NY
• Providers in Port Washington, 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 Jan 22, 2008; 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.