Provider Demographics
NPI:1891980116
Name:GERSHFELD, YURY (DDS)
Entity Type:Individual
Prefix:
First Name:YURY
Middle Name:
Last Name:GERSHFELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JULIAN
Other - Middle Name:
Other - Last Name:GERSHFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5160 VINELAND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-3888
Mailing Address - Country:US
Mailing Address - Phone:818-761-8899
Mailing Address - Fax:
Practice Address - Street 1:5160 VINELAND AVE STE 105
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3888
Practice Address - Country:US
Practice Address - Phone:818-761-8899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist