NPIMap

Organization Active NPI

Optimal Family Dentistry

  • General Practice Dentistry
  • Manchester, NH
National Provider Identifier
1215112511
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
03593 Issued in NH
Legal business name
OPTIMAL FAMILY DENTISTRY
Practice address
904 Hanover St
Manchester, NH 03104-5422
Phone
(603) 674-9590
NPI assigned
Jan 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Authorized official

Name
Dr. Aleksander E Khrkhryan, DMD
Title
Doctor
Phone
(603) 674-9590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 03593 NH Primary

Addresses

Primary practice location

904 Hanover St
Manchester, NH 03104-5422

Mailing address

904 Hanover St
Manchester, NH 03104-5422

Other identifiers 1

IdentifierTypeStateIssuer
30305087MedicaidNH

National Provider Directory

National Provider Directory

Locations

904 Hanover St
Manchester, NH 03104
Phone (603) 674-9590

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1215112511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 HANOVER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031045422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 HANOVER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031045422",
            "telephone_number": "603-674-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "KHRKHRYAN",
        "authorized_official_first_name": "ALEKSANDER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "603-674-9590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "03593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30305087",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.