Active NPI
George E Anastassov, DDS,MD
- Oral & Maxillofacial Surgery (D.M.D.)
- Dubuque, IA
National Provider Identifier
1174564322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- 10410
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01760705 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 042919 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crescent Community Health Center | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Dubuque, IA
- NPI 1720146319
IA
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.