Individual provider Active NPI

Anastasia V Mischenko, DDS

  • Endodontics
  • Chevy Chase, MD
National Provider Identifier
1285862250
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
13534 Issued in MD
Practice address
5454 Wisconsin Ave
Suite 815
Chevy Chase, MD 20815-6901
Phone
(301) 654-6077
Fax
(301) 654-0021
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 13534 MD Primary

Addresses

Primary practice location

5454 Wisconsin Ave
Suite 815
Chevy Chase, MD 20815-6901

Mailing address

513 Skidmore Blvd
Gaithersburg, MD 20877-1201
Phone (410) 802-5966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13534MDMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1285862250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 SKIDMORE BLVD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771201",
            "telephone_number": "410-802-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE 815",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-654-6077",
            "fax_number": "301-654-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISCHENKO",
        "first_name": "ANASTASIA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "13534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.