William Michael Sergakis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

88-143937-9922 Issued in UT

Practice address

7240 Highland Dr
Suite 102
Salt Lake City, UT 84121-5532

Phone

(801) 733-0864

Fax

(801) 733-4920

NPI assigned

Jun 22, 2006

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• UT PPO D-SNP

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188691200000",
    "number": "1043256308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 HIGHLAND DR",
            "address_2": "SUITE 102",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841215532",
            "telephone_number": "801-733-0864",
            "fax_number": "801-733-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 HIGHLAND DR",
            "address_2": "SUITE 102",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841215532",
            "telephone_number": "801-733-0864",
            "fax_number": "801-733-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGAKIS",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "88-143937-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sera Prognostics, Inc
• Mahnaz Seraji, RPH
• Mary Martine Serawop
• Erna Serezlic
• Dianna Louise Serfustini, LCSW
• Victoria Serpico, APRN
• Marian Serra, MD
• Abel Serrano
• Reymund Maramento Serrano
• Cecilia Serrato, DMD

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.