Individual provider Active NPI

George E Anastassov, DDS,MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Dubuque, IA
National Provider Identifier
1174564322
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
10410 Issued in IA
Practice address
1690 Elm St Ste 300
Dubuque, IA 52001-3679
Phone
(563) 690-0321
Fax
(563) 557-8488
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 10410 IA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 042919 NY

Addresses

Primary practice location

1690 Elm St Ste 300
Dubuque, IA 52001-3679

Mailing address

1690 Elm St Ste 300
Dubuque, IA 52001-3679
Phone (563) 690-2850

Other identifiers 1

IdentifierTypeStateIssuer
01760705MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20260319003301 IA Practitioner - Dentist 5799269536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1690 Elm St
Suite 300
Dubuque, IA 52001-3679

9425 Delegates Row
Indianapolis, IN 46240-3805

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042919NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
Crescent Community Health Center CurrentSince Feb 12, 2026 Accepting new patients

Locations

1690 Elm St
Ste 300
Dubuque, IA 52001
Phone (563) 690-2850

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ganastassov8147@nychhc.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1174564322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "563-690-2850",
            "fax_number": "563-239-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "563-690-0321",
            "fax_number": "563-557-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANASTASSOV",
        "first_name": "GEORGE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS,MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IA",
            "license": "10410",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "042919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01760705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.