Individual provider Active NPI

Athanasios Kokkas

  • General Practice Dentistry
  • Inverness, FL
National Provider Identifier
1356452932
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16761 Issued in FL
Practice address
2689 E Gulf to Lake Hwy
Inverness, FL 34453-3216
Phone
(352) 637-1114
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN16761 FL Primary

Addresses

Primary practice location

2689 E Gulf to Lake Hwy
Inverness, FL 34453-3216

Mailing address

2502 N Rocky Point Dr
Suite 1000-Credentialing
Tampa, FL 33607-1421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160211001762 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517261589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN16761FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Modiano Dental LLC Current Accepting new patients
Oral Health Management PLLC Past Accepting new patients
Coast Dental P.a. PastSince Jun 22, 2021 Accepting new patients
Coast Dental P.a. Past Accepting new patients
Adam Diasti DDS & Associates P.C. Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356452932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 N ROCKY POINT DR",
            "address_2": "SUITE 1000-CREDENTIALING",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2689 E GULF TO LAKE HWY",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533216",
            "telephone_number": "352-637-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKKAS",
        "first_name": "ATHANASIOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.