Active NPI
Dennis Andreopoulos, DDS
- Pediatric Dentistry
- Buckeye, AZ
National Provider Identifier
1114456647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 10305
- Practice address
- 675 S Watson Rd Ste 106
Buckeye, AZ 85326-3448 - Phone
- (632) 386-5430
- NPI assigned
- Jun 8, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 10305 | AZ | Primary |
Addresses
Primary practice location
675 S Watson Rd Ste 106
Buckeye, AZ 85326-3448
Mailing address
1631 Jasmine Ave
New Hyde Park, NY 11040-4338
Phone (516) 424-8550
Other practice location 1
1631 Jasmine Ave
New Hyde Park, NY 11040
Phone (516) 424-8550
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191007001394 | AZ | Order and Referring Only - Dentist | 2163753112 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10305 | AZ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1114456647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 JASMINE AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110404338",
"telephone_number": "516-424-8550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 S WATSON RD STE 106",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853263448",
"telephone_number": "632-386-5430"
}
],
"practiceLocations": [
{
"address_1": "1631 Jasmine Ave",
"address_purpose": "LOCATION",
"city": "New Hyde Park",
"state": "NY",
"postal_code": "11040",
"country_code": "US",
"telephone_number": "516-424-8550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDREOPOULOS",
"first_name": "DENNIS",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AZ",
"license": "10305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buckeye, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.