Georgios Maroulakos, DDS, MS, FACP

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

17972-875 Issued in WI

Practice address

1801 W Wisconsin Ave
Faculty Practice
Milwaukee, WI 53233-2186

Phone

(414) 288-0788

NPI assigned

Oct 6, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 11, 2016 through Jul 11, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437868800000",
    "number": "1063815975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W WISCONSIN AVE",
            "address_2": "FACULTY PRACTICE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332186",
            "telephone_number": "414-288-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W WISCONSIN AVE",
            "address_2": "FACULTY PRACTICE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332186",
            "telephone_number": "414-288-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROULAKOS",
        "first_name": "GEORGIOS",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, FACP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-06",
        "last_updated": "2015-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "27418",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WI",
            "license": "17972-875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Jean Maroda, PH.D, ABBP
• Carly Rae Marohl, LCSW, CSAC
• James Robert Maroney, D.D.S.
• Mary M Maroney, LMFT
• Sarah Marotz, PA
• Noah Marquardt, LPC-IT
• Sean Wesley Marquardt, PSY.D
• John Phillip Marquart, MD
• Michael Marquart, M.D.
• Pollyana Marques de Moura

• Prosthodontics in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Prosthodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.