Yelena Samokhvalova, D.D.S.
Dentist, General Practice in Brooklyn, NY. Individual provider (NPI-1).
NPI number1124259031
StatusActive
Last updated in NPPESJul 28, 2009
Details
- NPI
- 1124259031
- Entity type
- Individual (NPI-1)
- Name
- Yelena Samokhvalova
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 28, 2009
- Last updated
- Jul 28, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - OTHER (PHYSICIAN)
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 049114 | NY | Yes |
Practice location
7919 Flatlands AveBrooklyn, NY 11236-3531
Phone 718-209-1801
Mailing address
2811 E 26th StApt 3d
Brooklyn, NY 11235-2749
Phone 917-362-9292 · Fax 718-743-6920
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