Active NPIIndividual provider

Roman Izmailov, DDS

Dentist in Pomona, New York

NPI Number1487644456
Practice location
5C Medical Park Drive, Pomona, NY 10970-2443
Fax
845-364-0284
Last updated
October 5, 2012

Roman Izmailov is a Dentist based in Pomona, NY. Roman Izmailov practices in Pomona, NY and has the professional credentials of DDS. The NPI Number for Roman Izmailov is 1487644456 and holds a License No. 220102233400 (NJ). The current practice location address for Roman Izmailov is 5C Medical Park Drive, Pomona, NY 10970-2443 and can be reached out via phone at 845-364-9400 and via fax at 845-364-0284.

Provider Profile Details

NPI Number
1487644456
Provider Name
Roman Izmailov
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
5C Medical Park Drive, Pomona, NY 10970-2443
Phone Number
845-364-9400
Fax Number
845-364-0284
Primary Taxonomy
Dentist · 122300000X
Sole Proprietor
No
Provider Enumeration Date
October 21, 2005
Last Update Date
October 5, 2012
NPI Status
Active

Provider Business Practice Location Address Details

Address
5C Medical Park Drive
Pomona, NY 10970-2443
City
Pomona
Zip
10970-2443
Phone Number
845-364-9400
Fax Number
845-364-0284
Pomona, NY 10970Get directions →

Provider Business Mailing Address Details

Address
5C Medical Park Drive
Pomona, NY 10970-2443
City
Pomona
State
NY
Zip
10970-2443
Phone Number
845-364-9400
Fax Number
845-364-0284

License Information

License Number (1)
220102233400
License State (1)
NJ
Taxonomy (1)
Dentist · 122300000X · Primary
License Number (2)
047203
License State (2)
NY
Taxonomy (2)
Dentist · 122300000X

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Roman Izmailov, DDS?

The NPI number of Roman Izmailov, DDS is 1487644456. It was assigned on October 21, 2005 and is currently active in the NPPES registry.

What is the specialty of Roman Izmailov, DDS?

Roman Izmailov, DDS is registered under the primary taxonomy Dentist (code 122300000X), licensed in NJ under license number 220102233400.

Where does Roman Izmailov, DDS practice?

The practice location is 5C Medical Park Drive, Pomona, NY 10970-2443. The office can be reached at 845-364-9400 (phone) or 845-364-0284 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1487644456 directly on the NPPES registry website.

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