Active NPI
Constantine Stamatelakys, DDS
- Periodontics
- Greenfield, WI
National Provider Identifier
1235132192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 1847
- Practice address
- 2933 W Layton Ave
Greenfield, WI 53221-2626 - Phone
- (414) 282-2642
- NPI assigned
- May 24, 2005
- Last updated
- Apr 8, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1847 | WI | Primary |
Addresses
Primary practice location
2933 W Layton Ave
Greenfield, WI 53221-2626
Mailing address
2933 W Layton Ave
Greenfield, WI 53221-2626
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1847 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Periodontics LLC | Periodontics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Periodontics
- Greenfield, WI
- NPI 1770911976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270684800000",
"number": "1235132192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2933 W LAYTON AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532212626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2933 W LAYTON AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532212626",
"telephone_number": "414-282-2642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAMATELAKYS",
"first_name": "CONSTANTINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2010-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WI",
"license": "1847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, WI
- Steven M Sperry, MD
- Sue E Spivey, L.P.N.
- Gerald F Splittgerber, MD
- Sports Medicine & Orthopedic Center, S.C.
- SSC Greenfield Operating Company LLC (Southpointe Healthcare Center)
- Stans Bootery Inc (Stans Fit For Your Feet)
- Rick Staral, PHARMD
- Patricia Ann Stark, LPN
- Sharon Louise Cello Starks, PTA
- James Edward Steffen, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.