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Active NPI 1477244564 Individual Practitioner Male Practitioner

Michael M Ilyasov

Dentist - General Practice • Smithtown, NY

Professional Overview & Biography Verified Profile Summary

Michael Ilyasov is a registered healthcare professional specializing in Dentist - General Practice in Smithtown, NY. Practice services are available at 823 W JERICHO TPKE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

823 W Jericho Tpke

Smithtown, NY 117873216

Telephone 6315430550
Associated Practice Facility / Clinic
🏢 Vincent M. Mazurek, Dds, Pc Facility NPI 1871877365

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Smithtown, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
32 Specialists

Practicing in Smithtown, NY (8411 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-06
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 064310

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1639412323

Doctor of Dental Surgery

NPI 1750888012

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location October 06, 2024

Registered at 823 W JERICHO TPKE, SMITHTOWN, NY 117873216 (Tel: 6315430550)

📍
Updated Business Mailing Address October 06, 2024

Registered at 823 W JERICHO TPKE, SMITHTOWN, NY 117873216

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 06, 2024

Dentist (License #064310 in NY)

NPI Profile Active May 18, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location May 18, 2023

Registered at 8900 VAN WYCK EXPY, JAMAICA, NY 114182897 (Tel: 7182066982)

📍
Updated Business Mailing Address May 18, 2023

Registered at 8900 VAN WYCK EXPY, JAMAICA, NY 114182897 (Tel: 7182066982)

👤
Provider Name / Credentials Updated May 18, 2023

Recorded as MICHAEL ILYASOV

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 18, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477244564
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 18, 2023
Last Update: October 06, 2024
Sole Proprietor: No

Mailing Address

823 W Jericho Tpke

Smithtown, NY 117873216

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.