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General NPI Number Information
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NPI Number | 1205709458
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Entity Type | Organization
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Legal Business Name | YOUR DENTAL HOUSE, P.C.
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 549 E 26TH ST
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City | BROOKLYN
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State | NY
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Zip | 11210-1329
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Country | US
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Telephone | 929-900-2197
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Fax | 929-900-2198
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Provider Business Mailing Address
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Address Line | 549 E 26TH ST
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City | BROOKLYN
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State | NY
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Zip | 11210-1329
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Country | US
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Telephone | 929-900-2197
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Fax | 929-900-2198
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Authorized Official
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Title or Position | PRESIDENT
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Name | BORIS KAYLAKOV
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Credential | DDS
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Telephone | 929-900-2197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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