Annemarie O Athansios, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI02817500 Issued in NJ

Practice address

2 Franklin St
Cedar Grove, NJ 07009-2208

Phone

(973) 239-1820

NPI assigned

Jul 31, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Volha Bortnik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1811678063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 DOMINICK CT",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091332",
            "telephone_number": "646-330-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FRANKLIN ST",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070092208",
            "telephone_number": "973-239-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHANSIOS",
        "first_name": "ANNEMARIE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02817500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VOLHA",
            "last_name": "BORTNIK",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Periodontics in Cedar Grove, NJ
• Providers in Cedar Grove, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.