Active NPI
Maria Despina Georgakis, DMD
- General Practice Dentistry
- Lubbock, TX
National Provider Identifier
1154982015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35291
- Practice address
- 5607 Slide Rd Ste 200
Lubbock, TX 79414-4104 - Phone
- (806) 792-1750
- NPI assigned
- Jun 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35291 | TX | Primary |
Addresses
Primary practice location
5607 Slide Rd Ste 200
Lubbock, TX 79414-4104
Mailing address
5301 Chicago Ave Apt 4310
Lubbock, TX 79414-6011
Phone (909) 579-9701
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35291 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1154982015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 CHICAGO AVE APT 4310",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794146011",
"telephone_number": "909-579-9701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5607 SLIDE RD STE 200",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794144104",
"telephone_number": "806-792-1750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGAKIS",
"first_name": "MARIA DESPINA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-21",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.