Andrew Georgakopoulos, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

046704 Issued in NY

Practice address

469 Hawkins Ave
Suite 101
Lake Ronkonkoma, NY 11779-4276

Phone

(631) 588-8280

Fax

(631) 588-6258

NPI assigned

Jul 30, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Sachem Dental Group

  • General Practice Dentistry
  • Lake Ronkonkoma, NY
  • NPI 1568478196
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114932696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 HAWKINS AVE",
            "address_2": "SUITE 101",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794276",
            "telephone_number": "631-588-8280",
            "fax_number": "631-588-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 HAWKINS AVE",
            "address_2": "SUITE 101",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794276",
            "telephone_number": "631-588-8280",
            "fax_number": "631-588-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGAKOPOULOS",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "046704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katarina Fuchs
• Jose Nahun Galeas Soriano, M.D.
• Karen Gellert
• Genovese Drug Stores Inc (Rite Aid Pharmacy)
• Anthony Gentile, DDS
• George D Emmons DPM PC (Ronkonkoma Podiatry Center)
• Kian Gilardi
• Liane Marie Gilardi, BCCS
• Altagrace Gilbert Blanchard
• Vito Giovanniello, DDS

• Dentist in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Dentist in New York

• 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.
• 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.