Anastasios Athanasopoulos, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18590 Issued in MA

Practice address

475 Eastern Avenue
Lynn, MA 01902-1633

Phone

(781) 598-2232

Fax

(781) 598-2264

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992722896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 EASTERN AVENUE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019021633",
            "telephone_number": "781-598-2232",
            "fax_number": "781-598-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 EASTERN AVENUE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019021633",
            "telephone_number": "781-598-2232",
            "fax_number": "781-598-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHANASOPOULOS",
        "first_name": "ANASTASIOS",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "X12091",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0208981",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elsa Ascenso, MS, CCC-SLP
• Christine Elizabeth Ash, FNP
• Rita Asiegbunam, MSN
• Achiri Asongwed, MHC
• Aspire Developmental Services, Inc.
• Natallie Atkins
• Atlantic Coast Ophthalmology, P.C.
• Atlantic Dental
• Atlantic Home Health LLC
• Atlantic Rest Home NP, Inc.

• General Practice Dentistry in Lynn, MA
• Providers in Lynn, MA by specialty
• General Practice Dentistry in Massachusetts

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.