Northwest Institute of Cosmetic Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

7600 Issued in WA

Legal business name

NORTHWEST INSTITUTE OF COSMETIC DENTISTRY

Doing business as

Eric Der Ovanessian DDS PS Inc

Practice address

15710 NE 24TH Street
#B
Bellevue, WA 98008

Phone

(425) 643-7100

Fax

(425) 644-1426

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eric Der Ovanessian, DDSNPI 1831537224

Title

President

Phone

(425) 643-7100

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Eric Der Ovanessian DDS PS Inc Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Derovanessian, D.D.S

  • Dentist
  • Bellevue, WA
  • NPI 1831537224
  NPD (past) Authorized official

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1194898379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15710 NE 24TH STREET",
            "address_2": "#B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98008",
            "telephone_number": "425-643-7100",
            "fax_number": "425-644-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15710 NE 24TH STREET",
            "address_2": "#B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98008",
            "telephone_number": "425-643-7100",
            "fax_number": "425-644-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INSTITUTE OF COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "DER OVANESSIAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-643-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "7600",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "39144",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5034913",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eric Der Ovanessian DDS PS Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northwest Behavioral Associates
• Northwest Care LLC
• Northwest Center for Urology
• Northwest Gastroenterology Associates, Inc., P.S,.
• Northwest Healing and Wellness
• Northwest Integrative Medicine, PLLC
• Northwest Ketamine Clinics PLLC Dba Northwest Healing and Wellness (Northwest Healing and Wellness)
• Northwest Kidney Centers (Bellevue Kidney Center)
• Northwest Neuropsychology Learning and Behavioral Services
• Northwest Outpatient Anesthesia PLLC

• Dentist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.