Edward Louis Mustian III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005756 Issued in VA

Practice address

5700 Old Richmond Ave
Suite 8
Richmond, VA 23226-1828

Phone

(804) 285-9548

Fax

(804) 285-4887

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538259684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10307 AVENHAM WAY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232383692",
            "telephone_number": "804-741-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 OLD RICHMOND AVE",
            "address_2": "SUITE 8",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261828",
            "telephone_number": "804-285-9548",
            "fax_number": "804-285-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTIAN",
        "first_name": "EDWARD",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "0401005756",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Muscat
• Jarryd Mushatt-Valrie, LCSW
• Daniel James Musick, M.D.
• Heather Cheree Musolin, PHARM.D.
• Fareeza Taskeen Mustafa, MD
• John Andrew Mustian, D.D.S.
• Valerie A Mutchler-Fornili, M.D.
• Brian Mutchler, PSY.D.
• Andrew Muth, LPC
• Marjorie Anne Muth, RN, BSN, IBCLC

• General Practice Dentistry in Richmond, VA
• Providers in Richmond, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.