Elli Anna Kotsailidi, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

NA Issued in NY

Practice address

625 Elmwood Ave
Rochester, NY 14620-2913

Phone

(585) 275-1147

NPI assigned

May 15, 2019

Last updated

May 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1174189088",
    "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": "585-275-1147"
        },
        {
            "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": "585-275-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTSAILIDI",
        "first_name": "ELLI ANNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ellikots.com",
            "affiliation": "N",
            "endpointDescription": "url",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Periodontology",
            "address_1": "60 Crittenden Blvd Apt 427",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146204053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kamal Kothari, MD
• Shivangi Truptesh Kothari, MBBS
• Tarun Kothari, MD
• Theresa Lynn Kotin, RN
• David Kotok, M.D.
• Pavan Kottamasu, MD, MBA
• Robert M Kottmann, M.D.
• Carli Ann Kotula, PA
• Lisa Kotyra, NP
• Chavonne Kouassi

• Periodontics in Rochester, NY
• Providers in Rochester, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.