Edmond Aram Demirdjan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

047331 Issued in NY

Practice address

76 17 Eliot Avenue
Middle Village, NY 11379

Phone

(718) 426-6959

Fax

(718) 426-0342

NPI assigned

Nov 21, 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

Medicare fee-for-service enrollment

Enrolled in NY

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669547998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 17 ELIOT AVENUE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "11379",
            "telephone_number": "718-426-6959",
            "fax_number": "718-426-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 17 ELIOT AVENUE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "11379",
            "telephone_number": "718-426-6959",
            "fax_number": "718-426-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIRDJAN",
        "first_name": "EDMOND",
        "middle_name": "ARAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dedona
• Tamara Dekhkanova, OTR/L
• Luisa F Delgadillo
• Jesse Delman, LMSW
• Deluxe DME, Inc.
• Kathryn Diaz, MA,CCC-SLP,TSHH, BIL
• Danielle Difiore
• Digital Audiology Associates P C
• Michael Dimuro, DPM
• Joanna Dobkowska, OT

• Dentist in Middle Village, NY
• Providers in Middle Village, NY by specialty
• Dentist in New York

• 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.