George Koutsoukos DDS, Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GEORGE KOUTSOUKOS DDS, INC

Doing business as

Elite Smiles

Practice address

24155 Magic Mountain Pkwy
Valencia, CA 91355-3904

Phone

(661) 222-7724

Fax

(661) 222-7464

NPI assigned

Dec 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. George Kon Koutsoukos, D.D.S

Title

Owner

Phone

(661) 222-7724

Specialties & licenses 10

Addresses

Other names 1

• Elite Smiles Doing business as

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1134465040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24155 MAGIC MOUNTAIN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553904",
            "telephone_number": "661-222-7724",
            "fax_number": "661-222-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24155 MAGIC MOUNTAIN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553904",
            "telephone_number": "661-222-7724",
            "fax_number": "661-222-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE KOUTSOUKOS DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "KOUTSOUKOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "KON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-222-7724",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Valencia, CA
• Providers in Valencia, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.