Basilios C Costaras, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D008677 Issued in AZ

Practice address

10214 N Tatum Blvd Ste A1100
Phoenix, AZ 85028-4243

Phone

(602) 992-1486

Fax

(602) 992-6604

NPI assigned

Sep 11, 2009

Last updated

Mar 3, 2026By 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 3

Addresses

Other names 1

• Dr. Bill C Costaras Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Oral Surgery

Education

Case Western University School of Dental Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Orofacial Group IncGroup PAC ID 4981786308, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southwest Orofacial Group, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Phoenix, AZ
  • NPI 1487733572
  Medicare reassignment Care Compare group NPD
• Southwest Orofacial Group, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Mesa, AZ
  • NPI 1619707049
  NPD

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1053644880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10214 N TATUM BLVD STE A1100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284243",
            "telephone_number": "602-992-1486",
            "fax_number": "602-992-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10214 N TATUM BLVD STE A1100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284243",
            "telephone_number": "602-992-1486",
            "fax_number": "602-992-6604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20470 N Lake Pleasant Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853829708",
            "country_code": "US",
            "telephone_number": "602-992-1486",
            "fax_number": "602-992-6604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6116 E Arbor Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852066103",
            "country_code": "US",
            "telephone_number": "602-992-1486",
            "fax_number": "602-992-6604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTARAS",
        "first_name": "BASILIOS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-11",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008677",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D008677",
            "primary": true
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "AZ",
            "license": "D008677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BILL",
            "last_name": "COSTARAS",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John Albert Costa, MD
• Tara Costa, LAMFT
• Jesse Lee Costales, M.D.
• Theresa L. Costales, M.D.
• John Michael Costantino, D.O.
• Costco Wholesale Corporation (Costco Hearing Aid #465)
• Costco Wholesale Corporation (Costco Pharmacy #465)
• Costco Wholesale Corporation (Costco Hearing Aid #1058)
• Costco Wholesale Corporation (Costco Optical #1058)
• Costco Wholesale Corporation (Costco Hearing Aid #738)

• Oral and Maxillofacial Surgery (Dentist) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.