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DR. YAKOV KHAYDATOV DMD
NPI 1023249448
Dentist in Phoenix, AZ

Active since August 03, 2009PECOS Enrolled
5225 N 19TH AVE, SUITE C, PHOENIX, AZ 85015(602) 433-0313 Get Directions Write a Review

NPPES record last updated: December 3, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Yakov Khaydatov Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. YAKOV KHAYDATOV DMD (NPI 1023249448) is an individual dentist in Phoenix, Arizona, licensed in Arizona (7845) and active in the NPI registry since August 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023249448
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. YAKOV KHAYDATOVCredential: DMD
Location Address5225 N 19TH AVE, SUITE CPhoenix, AZ 85015-2903
Mailing Address110 E Joan D Arc AvePhoenix, AZ 85022-4705 · (602) 367-8456
Phone(602) 433-0313
Sole ProprietorNo
Enumeration DateAugust 3, 2009
Last NPPES UpdateDecember 3, 2009
✔ NPI 1023249448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in AZ · 7845
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
5225 N 19TH AVE, Phoenix, AZ 85015
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Yakov Khaydatov Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85015 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEALING HAVENS, PLLC
Chiropractor (Sports Physician)
5225 N 19TH AVE, SUITE E
PHOENIX, AZ 85015
Maricopa County (602) 841-7576
MARC S KAY DDJ
Dentist
5225 N 19TH AVE, #C
PHOENIX, AZ 85015
Maricopa County (602) 433-0313
MARK BUDOVITCH
Dentist
5225 N 19TH AVE, C
PHOENIX, AZ 85015
Maricopa County (602) 433-0313
MIRACLE CONSULTING
Community/Behavioral Health
5225 N 19TH AVE, SUITE B
PHOENIX, AZ 85015
Maricopa County (480) 593-7203
DR. VICTOR J. KHOURY D.C.
Chiropractor
5225 N 19TH AVE, SUITE E
PHOENIX, AZ 85015
Maricopa County (602) 274-8444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yakov Khaydatov's NPI number?

The NPI number for Yakov Khaydatov is 1023249448. It was assigned to this individual provider in the NPPES registry on August 3, 2009.

Where is Yakov Khaydatov located?

Yakov Khaydatov practices at 5225 N 19th Ave Suite C, Phoenix, AZ 85015. The listed phone number is (602) 433-0313.

What is Yakov Khaydatov's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Yakov Khaydatov enrolled in Medicare?

Yes. Yakov Khaydatov is registered in the Medicare PECOS enrollment system.

What insurance does Yakov Khaydatov accept?

Health plans from Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Arizona and Blue Cross and Blue Shield of Alabama and 14 other insurers list Yakov Khaydatov as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Yakov Khaydatov was last updated on December 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.