Individual provider Active NPI

Georgios Romanos, DDS, PHD, PROF.

  • Periodontics
  • Rochester, NY
National Provider Identifier
1144522590
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
000017 Issued in NY
Practice address
625 Elmwood Ave
Rochester, NY 14620-2913
Phone
(585) 276-4149
Fax
(585) 473-5254
NPI assigned
Nov 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 000017 NY Primary

Addresses

Primary practice location

625 Elmwood Ave
Rochester, NY 14620-2913

Mailing address

625 Elmwood Ave
Rochester, NY 14620-2913
Phone (585) 276-4149

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160105000088 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4183926421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
000017NYMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1144522590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202913",
            "telephone_number": "585-276-4149",
            "fax_number": "585-473-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202913",
            "telephone_number": "585-276-4149",
            "fax_number": "585-473-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANOS",
        "first_name": "GEORGIOS",
        "credential": "DDS, PHD, PROF.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "000017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.