Boris Yusupov, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0501301 Issued in NY

Practice address

17 Walt Whitman Rd
Huntington Station, NY 11746-3610

Phone

(631) 351-1222

NPI assigned

Aug 23, 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

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1922091222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WALT WHITMAN RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463610",
            "telephone_number": "631-351-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WALT WHITMAN RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463610",
            "telephone_number": "631-351-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0501301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William R Yelen
• Yetunde a Ogunbanwo NP in Family Health
• Claudine Young, LAC, LMT
• Your Wellness Pharmacy Ny Inc
• Suk-Hyeon Yun, MD
• Alexandros D Zouzias, M.D.
• Stephanie Zwerling, P.T.A

• General Practice Dentistry in Huntington Station, NY
• Providers in Huntington Station, 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 Feb 2, 2012; 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.