Dmitry Vodopyanov, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901021004 Issued in MI

Practice address

1500 E. Medical Center Drive
B1 208 Taubman Center
Ann Arbor, MI 48108-5018

Phone

(734) 232-6048

NPI assigned

Jun 14, 2013

Last updated

Jun 14, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1033557863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DRIVE",
            "address_2": "B1 208 TAUBMAN CENTER",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DRIVE",
            "address_2": "B1 208 TAUBMAN CENTER",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085018",
            "telephone_number": "734-232-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VODOPYANOV",
        "first_name": "DMITRY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.