Nikolas Marios Stathopoulos, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52005 Issued in CA

Practice address

19682 Hesperian Blvd
Suite 106
Hayward, CA 94541-4752

Phone

(510) 264-1410

Fax

(510) 264-1406

NPI assigned

Mar 4, 2012

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 CA

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

State licenses

Practice roles

Locations

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.

• Maria T Alarcon DDS Dental Corporation

  • Dental Clinic/Center
  • Hayward, CA
  • NPI 1467955369
  Medicare reassignment NPD

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

{
    "created_epoch": "1330819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330819200000",
    "number": "1144594441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19682 HESPERIAN BLVD",
            "address_2": "SUITE 106",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414752",
            "telephone_number": "510-264-1410",
            "fax_number": "510-264-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19682 HESPERIAN BLVD",
            "address_2": "SUITE 106",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414752",
            "telephone_number": "510-264-1410",
            "fax_number": "510-264-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHOPOULOS",
        "first_name": "NIKOLAS",
        "middle_name": "MARIOS",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-04",
        "last_updated": "2012-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Keller Staley, DDS
• Stanislaus County
• Stanislaus County
• Renee Marie Stanley
• Michael Vicente Stanton, PH.D.
• Parker Stein
• Susan Gwen Steineke, PA-C
• Kamran Malik Stephens
• Sterling Professional Concierge
• Steven John Avolicino

• General Practice Dentistry in Hayward, CA
• Providers in Hayward, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2012; 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.