Ilya Kvartin, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

016.0133960 Issued in VT

Practice address

62 Merchants Row Ste 104
Williston, VT 05495-4476

Phone

(802) 497-6310

NPI assigned

Aug 7, 2020

Last updated

Aug 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1982214623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338B PLAZA RD N",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103640",
            "telephone_number": "201-621-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MERCHANTS ROW STE 104",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054954476",
            "telephone_number": "802-497-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVARTIN",
        "first_name": "ILYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0133960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Williston, VT
• Providers in Williston, VT by specialty
• Dentist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.