Individual provider Active NPI

Eleni Callis-Dionyssopoulos, D.D.S.

  • General Practice Dentistry
  • Brownstown, MI
National Provider Identifier
1124150438
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D17751 Issued in MI
Practice address
25110 Telegraph Rd
Brownstown, MI 48134-1072
Phone
(734) 783-5255
Fax
(734) 783-5228
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D17751 MI Primary

Addresses

Primary practice location

25110 Telegraph Rd
Brownstown, MI 48134-1072

Mailing address

25110 Telegraph Rd
Brownstown, MI 48134-1072
Phone (734) 783-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D17751MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
B. a. Burkhart, D. D. S., P.C. General Practice Past Accepting new patients
Eleni Callis DDS PLLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1124150438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25110 TELEGRAPH RD",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481341072",
            "telephone_number": "734-783-5255",
            "fax_number": "734-783-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25110 TELEGRAPH RD",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481341072",
            "telephone_number": "734-783-5255",
            "fax_number": "734-783-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLIS-DIONYSSOPOULOS",
        "first_name": "ELENI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D17751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownstown, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.