Petros Panagos, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

052164 Issued in NY

Practice address

601 Franklin Ave Ste 101
Garden City, NY 11530-5795

Phone

(516) 741-4415

NPI assigned

Aug 21, 2007

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Apr 8, 2026 through Apr 8, 2028

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Rodney Rastegar DDS PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Garden City, NY
  • NPI 1508195975
  NPD (past)

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1265625537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 FRANKLIN AVE",
            "address_2": "SUITE 101",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305795",
            "telephone_number": "516-741-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 FRANKLIN AVE STE 101",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305795",
            "telephone_number": "516-741-4415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Lakeville Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401600",
            "country_code": "US",
            "telephone_number": "516-437-2666",
            "fax_number": "516-358-6954",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23 Bond St Ste 8",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110212025",
            "country_code": "US",
            "telephone_number": "516-482-0329",
            "fax_number": "516-482-0401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANAGOS",
        "first_name": "PETROS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "052164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pain Medicine PC
• Ivan Pak, DDS
• Jae Hyeong Pak, DDS
• Susan M Palleschi, MD
• Marco Palmieri, DO
• Robert Panariello, PT
• Constantine Antony Pandazis, D.C.
• Sarai Paniccia, D.O.
• Mary Andrea Panopoulos
• Ani Panoyan, O.D.

• Oral and Maxillofacial Surgery (Dentist) in Garden City, NY
• Providers in Garden City, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.