Individual provider Active NPI

John Andrew Mustian, D.D.S.

  • General Practice Dentistry
  • Richmond, VA
National Provider Identifier
1861805392
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401414450 Issued in VA
Practice address
5700 Old Richmond Ave Ste B8
Richmond, VA 23226-1828
Phone
(804) 285-9548
NPI assigned
Jun 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401414450 VA Primary

Addresses

Primary practice location

5700 Old Richmond Ave Ste B8
Richmond, VA 23226-1828

Mailing address

1745 W Cary St
Richmond, VA 23220-5308
Phone (804) 405-8936

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160607001640 VA Order and Referring Only - DentistPractitioner - Dentist 5597055384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401414450VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1861805392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 W CARY ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232205308",
            "telephone_number": "804-405-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 OLD RICHMOND AVE STE B8",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261828",
            "telephone_number": "804-285-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTIAN",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.