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LARISA ILYUTOVICH DDS PC
NPI 1609954064
Dentist - General Practice in Fort Lee, NJ

Active since November 02, 2006
301 BRIDGE PLAZA NORTH, 2ND FLR, FORT LEE, NJ 07024(201) 346-4660(201) 346-1116 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Larisa Ilyutovich Dds Pc NPPES

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

LARISA ILYUTOVICH DDS PC (NPI 1609954064) is a healthcare organization registered as a general practice in Fort Lee, New Jersey and active in the NPI registry since November 2006. The organization lists Larisa Ilyutovich, President Owner, as its authorized official.

NPPES Registry Identity

NPI1609954064
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameLARISA ILYUTOVICH DDS PC
Location Address301 BRIDGE PLAZA NORTH, 2ND FLRFort Lee, NJ 07024
Mailing Address301 Bridge Plaza North, 2nd FlrFort Lee, NJ 07024 · (201) 346-4660 · Fax (201) 346-1116
Phone(201) 346-4660
Fax(201) 346-1116
Organization SubpartNo
Authorized OfficialLarisa IlyutovichPresident Owner · (201) 346-4660
Enumeration DateNovember 2, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1609954064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NJ · DI020299
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
301 BRIDGE PLAZA NORTH, Fort Lee, NJ 07024
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Other Identifiers 1

Medicaid8797404NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Larisa Ilyutovich Dds PC's NPI number?

The NPI number for Larisa Ilyutovich Dds PC is 1609954064. It was assigned to this organization in the NPPES registry on November 2, 2006.

Where is Larisa Ilyutovich Dds PC located?

Larisa Ilyutovich Dds PC is located at 301 Bridge Plaza North 2nd Flr, Fort Lee, NJ 07024. The listed phone number is (201) 346-4660.

What is Larisa Ilyutovich Dds PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Larisa Ilyutovich Dds PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.