Individual provider Active NPI

Efthimios C Anastassatos, DMD

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1275715260
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4096 Issued in AZ
Practice address
4350 E Ray Road
BLDG 5 Ste 122
Phoenix, AZ 85044-4703
Phone
(480) 759-2020
Fax
(480) 759-2915
NPI assigned
Nov 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4096 AZ Primary

Addresses

Primary practice location

4350 E Ray Road
BLDG 5 Ste 122
Phoenix, AZ 85044-4703

Mailing address

4350 E Ray Road
BLDG 5 Ste 122
Phoenix, AZ 85044-4703
Phone (480) 759-2020

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4096AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis K Streich DDS PC Dentist Past Accepting new patients
Eca Investments, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1275715260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 E RAY ROAD",
            "address_2": "BLDG 5 STE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-759-2020",
            "fax_number": "480-759-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E RAY ROAD",
            "address_2": "BLDG 5 STE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-759-2020",
            "fax_number": "480-759-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANASTASSATOS",
        "first_name": "EFTHIMIOS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "4096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.