Active NPI
Harry E Tatoian Jr., D.M.D.
- Dentist
- Roanoke, VA
National Provider Identifier
1972634921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401414742
- Practice address
- 3716 Melrose Ave NW
Roanoke, VA 24017-2716 - Phone
- (540) 362-0360
- NPI assigned
- Mar 8, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11936 | MA | |
| Dentist | 122300000X | 0401414742 | VA | Primary |
Addresses
Primary practice location
3716 Melrose Ave NW
Roanoke, VA 24017-2716
Mailing address
PO Box 3475
Pawleys Island, SC 29585-3475
Phone (781) 964-1233
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0271071 | Medicaid | MA | |
| 00000179289 | Other | MA | UNITED CONCORDIA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191113000740 | VA | Order and Referring Only - Dentist | 7719319714 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11936 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1972634921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3475",
"city": "PAWLEYS ISLAND",
"state": "SC",
"postal_code": "295853475",
"telephone_number": "781-964-1233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3716 MELROSE AVE NW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240172716",
"telephone_number": "540-362-0360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATOIAN",
"first_name": "HARRY",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "11936",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401414742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0271071",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "00000179289",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.