Terry Kristallis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1000559 Issued in DC

Practice address

910 17TH St NW
Suite 108
Washington, DC 20006-2601

Phone

(202) 887-1909

Fax

(202) 887-0417

NPI assigned

Apr 13, 2007

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 DC

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1447475819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 17TH ST NW",
            "address_2": "SUITE 108",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200062601",
            "telephone_number": "202-887-1909",
            "fax_number": "202-887-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 17TH ST NW",
            "address_2": "SUITE 108",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200062601",
            "telephone_number": "202-887-1909",
            "fax_number": "202-887-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTALLIS",
        "first_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "1000559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayashree Krishnan, MD
• Naveen Mohan Krishnan, BS, MPHIL
• Shilpa Krishnan, PHD
• Sarah Metz Krissoff, FNP-BC
• Ross Kristal, M.D.
• Thanos T Kristallis, DDS
• Ervand Kristosturyan
• Irene Melisa Kritikos
• Kritis Dasgupta MD PC
• Ruth Kriz, APRN

• General Practice Dentistry in Washington, DC
• Providers in Washington, DC by specialty
• General Practice Dentistry in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.