Individual provider Active NPI

Emiliya Yakubova, D.D.S

  • Dentist
  • New York, NY
National Provider Identifier
1952422149
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
050495 Issued in NY
Practice address
161 Madison Ave
Suite 8 NE
New York, NY 10016-5421
Phone
(212) 532-3893
NPI assigned
Apr 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 050495 NY Primary

Addresses

Primary practice location

161 Madison Ave
Suite 8 NE
New York, NY 10016-5421

Mailing address

8344 Lefferts Blvd Apt 4R
Kew Gardens, NY 11415-2583
Phone (718) 846-5018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180201001194 NY Order and Referring Only - DentistPractitioner - Dentist 7214297746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050495NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Dental Care of Ny Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: eyakubova684622@nychhc.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952422149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8344 LEFFERTS BLVD APT 4R",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152583",
            "telephone_number": "718-846-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MADISON AVE",
            "address_2": "SUITE 8 NE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165421",
            "telephone_number": "212-532-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUBOVA",
        "first_name": "EMILIYA",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "050495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.