Active NPI
Edit Avodian, DDS
- Dentist
- Sunnyside, NY
National Provider Identifier
1508112285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62142
- Practice address
- 4322 45TH St Apt 4a
Sunnyside, NY 11104-2349 - Phone
- (818) 269-6610
- NPI assigned
- Jul 31, 2012
- Last updated
- Feb 13, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 056126 | NY | |
| Dentist | 122300000X | 62142 | CA | Primary |
Addresses
Primary practice location
4322 45TH St Apt 4a
Sunnyside, NY 11104-2349
Mailing address
4322 45TH St Apt 4a
Sunnyside, NY 11104-2349
Phone (818) 269-6610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056126 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delfin Tio DDS Inc. | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Angeles Crest Dentistry
- General Practice Dentistry
- Glendale, CA
- NPI 1891439188
-
dba Angeles Crest Dentistry
- General Practice Dentistry
- Glendale, CA
- NPI 1881744902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1508112285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4322 45TH ST APT 4A",
"city": "SUNNYSIDE",
"state": "NY",
"postal_code": "111042349",
"telephone_number": "818-269-6610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4322 45TH ST APT 4A",
"city": "SUNNYSIDE",
"state": "NY",
"postal_code": "111042349",
"telephone_number": "818-269-6610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVODIAN",
"first_name": "EDIT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-31",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "056126",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyside, NY
- Suzanne Ashman-Kipervaser, M.S., CCC-SLP
- Asian Adult Day Care Center
- Astoria Advance Foot Care (Sunnyside Family Foot Care)
- Astoria Advanced Footcare (Sunnyside Family Foot Care)
- Ivette Astudillo Javier, RDN
- Esin Aydinoglu
- Junelle Jodeen Bailey, RN
- Mihaela Balaescu, MD
- Jorge Alberto Ballestas, M.S. CCC-SLP
- Michelle Bangiyev, OD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.