| Fusion Dental, P.c. | |
|
2101 Bay Ridge Parkway Medical/dental Center Brooklyn NY 11204 | |
| (718) 232-6996 | |
| Not Available |
| Full Name | Fusion Dental, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 2101 Bay Ridge Parkway, Brooklyn, New York |
| Authorized Official Name and Position | Yelena Yurchenko (PRESIDENT) |
| Authorized Official Contact | 7182326996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fusion Dental, P.c. 2101 Bay Ridge Parkway Medical/dental Center Brooklyn NY 11204 Ph: (718) 232-6996 | Fusion Dental, P.c. 2101 Bay Ridge Parkway Medical/dental Center Brooklyn NY 11204 Ph: (718) 232-6996 |
| NPI Number | 1073076980 |
|---|---|
| Provider Enumeration Date | 04/08/2019 |
| Last Update Date | 04/08/2019 |
| Medicare PECOS PAC ID | 4587997317 |
|---|---|
| Medicare Enrollment ID | O20190611002131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073076980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Gennady Dranovsky |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1639393754 PECOS PAC ID: 0547394595 Enrollment ID: I20100813000050 |
| Provider Name | Yelena Yurchenko |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1700044922 PECOS PAC ID: 4789982539 Enrollment ID: I20190408000611 |
| Provider Name | Grigoriy Yusupov |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023279254 PECOS PAC ID: 2860801867 Enrollment ID: I20210504000515 |
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