Georgia Kougentakis, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

053641 Issued in NY

Practice address

2420 National Dr
Brooklyn, NY 11234-6836

Phone

(917) 981-5103

NPI assigned

Jan 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1265617237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 NATIONAL DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346836",
            "telephone_number": "917-981-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 NATIONAL DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346836",
            "telephone_number": "917-981-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUGENTAKIS",
        "first_name": "GEORGIA",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "053641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Mary Kotuby, PH.D.
• Roshni Kotwani, DO
• Sandra H. Kotzen, L.C.S.W.
• Selwyn Kotzen, LCSW
• Nafila Kouba, M.D.
• Marianthi Kougentakis
• Golnoush Kouhihabibidehkordi, MD
• Irina Koukharenko, M.D.
• Chaman Lal Koul, DDS
• Diana Koulikova, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.