Provider Demographics
NPI:1457532459
Name:YIGAL PRILUTSKY, D.M.D., INC.
Entity Type:Organization
Organization Name:YIGAL PRILUTSKY, D.M.D., INC.
Other - Org Name:BEVERLYWOOD DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YIGAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRILUTSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-929-9572
Mailing Address - Street 1:8515 VENICE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-2548
Mailing Address - Country:US
Mailing Address - Phone:310-839-3900
Mailing Address - Fax:310-839-3332
Practice Address - Street 1:8515 VENICE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-2548
Practice Address - Country:US
Practice Address - Phone:310-839-3900
Practice Address - Fax:310-839-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental