Nicholas Andreas Anastassatos, D.D.S
Individual provider Active NPI General Practice Dentistry · Carson City, NV
NPI 1992920607 · NPPES record last updated Apr 11, 2011
Key facts
- NPI
- 1992920607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4627 (NV)
- Practice address
- 913 Mountain St.
Carson City, NV 89703 - Phone
- (775) 882-4433
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160421001809 | NV | Order and Referring Only - Dentist |
4385943570 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MPS Dental LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4627 | NV | Yes |
Addresses
Primary practice location
913 Mountain St.
Carson City, NV 89703
Mailing address
6580 South McCarran Blvd
Ste B
Reno, NV 89509-6140
Phone (775) 825-9353
Other providers in Carson City, NV
- American Home Companion, Inc.
- Aarona79 Mykle Ames
- Mahyar Amjadi
- John Joseph Amorati
- Kathi Lynne Amrhein
- Kaja Anderson-Howard
- Ellie Danielle Anderson
- Justine Anderson
- Laura Jeannette Anderson
- Melissa Anderson
All providers in Carson City, NV · General Practice Dentistry in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.