Active NPI
Richard Stephen Demerjian, DMD
- Dentist
- Hyannis, MA
National Provider Identifier
1780733683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10633
- Practice address
- 276 Barnstable Rd
Northeast Dental
Hyannis, MA 02601 - Phone
- (508) 771-0500
- Fax
- (508) 771-0503
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10633 | MA | Primary |
Addresses
Primary practice location
276 Barnstable Rd
Northeast Dental
Hyannis, MA 02601
Mailing address
300 E Long Lake Rd
St 311 Great Expression Dental Centers
Bloomfield Hills, MI 48304
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10633 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780733683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E LONG LAKE RD",
"address_2": "ST 311 GREAT EXPRESSION DENTAL CENTERS",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "48304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "276 BARNSTABLE RD",
"address_2": "NORTHEAST DENTAL",
"city": "HYANNIS",
"state": "MA",
"postal_code": "02601",
"telephone_number": "508-771-0500",
"fax_number": "508-771-0503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMERJIAN",
"first_name": "RICHARD",
"middle_name": "STEPHEN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "10633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyannis, MA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.