| Dr Grigoriy Yusupov, DDS | |
|
65 Jefferson Avenue, Elizabeth, NJ 07201 | |
| (908) 527-8688 | |
| (908) 527-9399 |
| Full Name | Dr Grigoriy Yusupov |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Experience | 29 Years |
| Location | 65 Jefferson Avenue, Elizabeth, New Jersey |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023279254 | NPI | - | NPPES |
| 9069909 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 220102207500 (New Jersey) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fusion Dental, P.c. | 4587997317 | 3 |
| Entity Name | Fusion Dental, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073076980 PECOS PAC ID: 4587997317 Enrollment ID: O20190611002131 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Grigoriy Yusupov, DDS 65 Jefferson Avenue, Elizabeth, NJ 07201 Ph: (908) 527-8688 | Dr Grigoriy Yusupov, DDS 65 Jefferson Avenue, Elizabeth, NJ 07201 Ph: (908) 527-8688 |
Dr. Svetlana Konstantinova, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 707 Elizabeth Ave, Elizabeth, NJ 07201 Phone: 908-354-1500 | |
Dr. Pardeep Kaur Sidhu, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 465 North Ave, Elizabeth, NJ 07208 Phone: 908-352-4438 Fax: 908-352-4525 | |
Aleksey Novakhov, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 611 Jefferson Ave, Elizabeth, NJ 07201 Phone: 908-353-5400 Fax: 908-353-7273 | |
Dr. Herawati Tirtadjaja Kandou, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 35 Jefferson Avenue, Elizabeth, NJ 07201 Phone: 908-354-1188 Fax: 908-352-7390 | |
Dr. Luis Rafael Rojas Martinez, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 915 Elizabeth Ave, Elizabeth, NJ 07201 Phone: 908-325-9666 | |
Dr. Lisa M. Jacobson, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 230 W Jersey St, Medical Arts Building, Suite 209, C/o Dr. W. Silverman, Elizabeth, NJ 07202 Phone: 908-229-1345 Fax: 908-353-1888 |