Larisa Ilyutovich DDS PC

General Practice Dentistry · Fort Lee, NJ

Organization Active NPI

NPI number 1609954064

Practice location

301 Bridge Plaza North
2ND Flr
Fort Lee, NJ 07024
Phone
(201) 346-4660
Fax
(201) 346-1116

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NPI record

NPI
1609954064
Entity type
Organization (Type 2)
Enumeration date
November 2, 2006
Last updated
August 22, 2020
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X DI020299 NJ

Authorized official

Name
Mrs. Larisa Ilyutovich, DDS
Title
President Owner
Phone
(201) 346-4660

About Larisa Ilyutovich DDS PC

Larisa Ilyutovich DDS PC is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 301 Bridge Plaza North, 2ND Flr, Fort Lee, NJ 07024. The NPI number 1609954064 was assigned on November 2, 2006 and the record was last updated on August 22, 2020.

Larisa Ilyutovich DDS PC lists a license in the registry: #DI020299 (NJ) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mrs. Larisa Ilyutovich, DDS, President Owner.

Frequently asked questions

What is the NPI number of Larisa Ilyutovich DDS PC?

The NPI number is 1609954064.

What is the phone number of Larisa Ilyutovich DDS PC?

The phone number listed for the practice location is (201) 346-4660.

Where is Larisa Ilyutovich DDS PC located?

301 Bridge Plaza North, 2ND Flr, Fort Lee, NJ 07024.

What is the taxonomy code for Larisa Ilyutovich DDS PC?

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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