Active NPI
Georgios Kotsakis, DDS, PHD
- Periodontics
- Newark, NJ
National Provider Identifier
1275909467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 01644
- Practice address
- 110 Bergen Street
Newark, NJ 07103 - Phone
- (973) 972-4242
- NPI assigned
- Aug 11, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DF60582867 | WA | |
| Periodontics | 1223P0300X | 01644 | NJ | Primary |
Addresses
Primary practice location
110 Bergen Street
Newark, NJ 07103
Mailing address
110 Bergen Street
D800
Newark, NJ 07103
Phone (973) 972-7224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1159275 | Medicaid | NJ |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01644 | NJ | MD | Periodontist |
| DF60582867 | WA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778025600000",
"number": "1275909467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BERGEN STREET",
"address_2": "D800",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07103",
"telephone_number": "973-972-7224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BERGEN STREET",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07103",
"telephone_number": "973-972-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTSAKIS",
"first_name": "GEORGIOS",
"credential": "DDS, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-11",
"last_updated": "2026-05-06",
"certification_date": "2026-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WA",
"license": "DF60582867",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "01644",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1159275",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.