Individual provider Active NPI

Hagop Hamparsoumian, DDS

  • Dentist
  • Mount Vernon, NY
National Provider Identifier
1457410631
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
039881 Issued in NY
Practice address
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Phone
(914) 699-7200
Fax
(914) 699-0837
NPI assigned
Dec 6, 2006
Last updated
Dec 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0398811 NY
Dentist 122300000X 039881 NY Primary

Addresses

Primary practice location

107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550

Mailing address

107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Phone (914) 699-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20151123001509 NY Order and Referring Only - DentistPractitioner - Dentist 9537469697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0398811NYMDDentist
039881NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1457410631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WEST 4TH STREET",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "10550",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WEST 4TH STREET",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "10550",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPARSOUMIAN",
        "first_name": "HAGOP",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0398811",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "039881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.