NPIMap

Organization Active NPI

Dr. Yury B. Geylikman, a Professional Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Palmdale, CA
National Provider Identifier
1942490834
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
2205 E Palmdale Blvd
Palmdale, CA 93550-1316
Phone
(323) 656-9111
Fax
(323) 650-9669
NPI assigned
Jul 27, 2007
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; PHD
Title
Ceo
Phone
(323) 656-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 41255 CA Primary

Addresses

Primary practice location

2205 E Palmdale Blvd
Palmdale, CA 93550-1316

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
B41255-02OtherCADENTICAL

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.

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": "1942490834",
    "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": "2205 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935501316",
            "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "41255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B41255-02",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, 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.