Individual provider Active NPI

Ashot Hovhannisyan, DMD

  • Dentist
  • Rutland, VT
National Provider Identifier
1629794987
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
016.0134279 Issued in VT
Practice address
474 Holiday Dr Ste 1
Rutland, VT 05701-4889
Phone
(305) 699-4488
NPI assigned
Oct 18, 2022
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN27571 FL
Dentist 122300000X 016.0134279 VT Primary

Addresses

Primary practice location

474 Holiday Dr Ste 1
Rutland, VT 05701-4889

Mailing address

474 Holiday Dr Ste 1
Rutland, VT 05701-4889
Phone (305) 699-4488

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
DN27571FLMDDentist
016.0134279VTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nathaniel Durtschi DMD PA PastSince Oct 1, 2022 Accepting new patients

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1629794987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 HOLIDAY DR STE 1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014889",
            "telephone_number": "305-699-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 HOLIDAY DR STE 1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014889",
            "telephone_number": "305-699-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVHANNISYAN",
        "first_name": "ASHOT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27571",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0134279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.