Individual provider Active NPI

George Trakakis, DDS

  • General Practice Dentistry
  • Aurora, IL
National Provider Identifier
1316018138
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019022385 Issued in IL
Practice address
4405 Fox Valley Center Dr
Aurora, IL 60504-4116
Phone
(630) 506-6721
Fax
(216) 584-1007
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019022385 IL Primary

Addresses

Primary practice location

4405 Fox Valley Center Dr
Aurora, IL 60504-4116

Mailing address

4405 Fox Valley Center Dr
Aurora, IL 60504-4116
Phone (630) 506-6721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20160520001627 IL Order and Referring Only - DentistPractitioner - Dentist 3375832959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
019022385ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
George J. Trakakis D.D.S. & Associates (Fox Valley), LTD. General Practice PastSince Dec 3, 2023 Accepting new patients

Organizations & group practices 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1316018138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 FOX VALLEY CENTER DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044116",
            "telephone_number": "630-506-6721",
            "fax_number": "216-584-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 FOX VALLEY CENTER DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044116",
            "telephone_number": "630-506-6721",
            "fax_number": "216-584-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAKAKIS",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.