Konstantinos Vazouras, DDS, MPHIL, MDSC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN1859085 Issued in MA

Practice address

1 Kneeland St
Boston, MA 02111-1527

Phone

(617) 636-6585

NPI assigned

Jul 23, 2013

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

Medicare fee-for-service enrollment

Enrolled in CT

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

State licenses

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649612235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "06111",
            "telephone_number": "617-636-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300001",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZOURAS",
        "first_name": "KONSTANTINOS",
        "name_prefix": "Dr.",
        "credential": "DDS, MPHIL, MDSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "DN1859085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Vavken
• Demetrios Vavvas, M.D.,PHD
• Eduard A Vaynberg, MD
• Sonya M. Vaziri, MD
• Aria Vazirnia, M.D.
• Borja Vazquez Roso, MA
• Belkis Vazquez, ARNP
• Christopher Samuel Vazquez
• Lianet Vazquez, MD
• Sara E Vazquez, MD

• Prosthodontics in Boston, MA
• Providers in Boston, MA by specialty
• Prosthodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.