Michael M. Ilyasov

General Practice Dentistry · Smithtown, NY

Individual Active NPI

NPI number 1477244564

Practice location

823 W Jericho Tpke
Smithtown, NY 11787-3216
Phone
(631) 543-0550

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NPI record

NPI
1477244564
Entity type
Individual (Type 1)
Enumeration date
May 18, 2023
Last updated
October 6, 2024
Certified
October 6, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 064310 NY

About Michael Ilyasov

Michael M. Ilyasov is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 823 W Jericho Tpke, Smithtown, NY 11787-3216. The NPI number 1477244564 was assigned on May 18, 2023 and the record was last updated on October 6, 2024.

Michael Ilyasov lists a license in the registry: #064310 (NY) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael M. Ilyasov?

The NPI number is 1477244564.

What is the phone number of Michael Ilyasov?

The phone number listed for the practice location is (631) 543-0550.

Where is Michael Ilyasov located?

823 W Jericho Tpke, Smithtown, NY 11787-3216.

What is the taxonomy code for Michael Ilyasov?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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