Organization Active NPI

Lev Tomashevsky DDS, LLC

  • General Practice Dentistry
  • Gaithersburg, MD
National Provider Identifier
1710121645
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13280 Issued in MD
Legal business name
LEV TOMASHEVSKY DDS, LLC
Practice address
220 Main St
Gaithersburg, MD 20878-5471
Phone
(301) 948-0058
Fax
(301) 977-3184
NPI assigned
Apr 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Mr. Anto Tatarian
Title
Business Manager
Phone
(240) 243-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 13280 MD Primary

Addresses

Primary practice location

220 Main St
Gaithersburg, MD 20878-5471

Mailing address

220 Main St
Gaithersburg, MD 20878-5471
Phone (301) 948-0058

Other names 1

  • Robert J kelly DDS & Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120124000808 MD DME Supplier - Oral Surgery - Dentist 3274700752 Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1710121645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 MAIN ST",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785471",
            "telephone_number": "301-948-0058",
            "fax_number": "301-977-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MAIN ST",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785471",
            "telephone_number": "301-948-0058",
            "fax_number": "301-977-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEV TOMASHEVSKY DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-22",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "TATARIAN",
        "authorized_official_first_name": "ANTO",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "240-243-0500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert J kelly DDS & Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.