Individual provider Active NPI

Vasiliki Moutopoulos, DMD

  • General Practice Dentistry
  • Ocean, NJ
National Provider Identifier
1588312847
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02884100 Issued in NJ
Practice address
922 NJ-35
Ocean, NJ 07712
Phone
(848) 217-2029
NPI assigned
Mar 16, 2022
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02884100 NJ Primary

Addresses

Primary practice location

922 NJ-35
Ocean, NJ 07712

Mailing address

120 Neilson St Apt 501
New Brunswick, NJ 08901-1464
Phone (718) 440-7870

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
22DI02884100NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pavlushkin Dental LLC General Practice CurrentSince Dec 3, 2023 Accepting new patients

Locations

922 Route 35
Ocean, NJ 07712
Phone (848) 217-2029

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1588312847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NEILSON ST APT 501",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011464",
            "telephone_number": "718-440-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 NJ-35",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "848-217-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTOPOULOS",
        "first_name": "VASILIKI",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02884100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.