George Andrew Souris, DDS, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30018793 Issued in OH

Practice address

26777 Lorain Rd
Suite 214
North Olmsted, OH 44070-3200

Phone

(440) 734-1146

Fax

(440) 734-6716

NPI assigned

Aug 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093724585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26777 LORAIN RD",
            "address_2": "SUITE 214",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703200",
            "telephone_number": "440-734-1146",
            "fax_number": "440-734-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26777 LORAIN RD",
            "address_2": "SUITE 214",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703200",
            "telephone_number": "440-734-1146",
            "fax_number": "440-734-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURIS",
        "first_name": "GEORGE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30018793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.