Antonio Stavros Ganios, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.034004 Issued in IL

Practice address

5700 Dempster St
Morton Grove, IL 60053-3040

Phone

(847) 965-6223

NPI assigned

Jun 17, 2019

Last updated

Jan 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Perry Danos DDS PC

  • General Practice Dentistry
  • Morton Grove, IL
  • NPI 1578648317
  NPD (past)
• David J. Farinacci D.D.S., P.C.

  dba Farinacci Dental Care

  • Dental Clinic/Center
  • North Canton, OH
  • NPI 1831952241
  NPD (past)

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1265092969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DEMPSTER ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 DEMPSTER ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533040",
            "telephone_number": "847-965-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANIOS",
        "first_name": "ANTONIO",
        "middle_name": "STAVROS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025804",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.034004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Joseph Freda
• Freedom Woods, Inc.
• Kirsten Fugate
• Peter J Galdoni, D.D.S.
• Divya Gandhi
• Penelope Danos Ganios
• Rowena Antonio Garcia, D.M.D.
• Jonathan Garrett, P.A.
• Jeffrey W Gatti, PHARMD
• Elijah Don Gebre, RBT-18-49343

• General Practice Dentistry in Morton Grove, IL
• Providers in Morton Grove, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.