George A Mandelaris, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

019024971 Issued in IL

Practice address

1S224 Summit Ave
Oakbrook Terrace, IL 60181-3983

Phone

(630) 627-3930

Fax

(630) 627-2148

NPI assigned

Apr 19, 2007

Last updated

Mar 24, 2011By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Periodontal Medicine and Surgical Specialists, LLC

  • Periodontics
  • Chicago, IL
  • NPI 1386098390
  Authorized official Same address or phone
• Periodontal Medicine and Surgical Specialists, LLC

  • Periodontics
  • Park Ridge, IL
  • NPI 1588703490
  Authorized official Same address or phone
• Periodontal Medicine and Surgical Specialists, LLC

  • Dental Clinic/Center
  • Oakbrook Terrace, IL
  • NPI 1811036718
  Authorized official Same address or phone

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1356568513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S224 SUMMIT AVE",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813983",
            "telephone_number": "630-627-3930",
            "fax_number": "630-627-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S224 SUMMIT AVE",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813983",
            "telephone_number": "630-627-3930",
            "fax_number": "630-627-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELARIS",
        "first_name": "GEORGE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019024971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lutheran Child and Family Service of Illinois
• Luxottica of America Inc (For Eyes (254))
• Gina Magiet, PT, DPT
• Fatima Zahra Malik
• Mall Pharmacy, Inc (Scripts Rx Pharmacy)
• Stewart R Mann, M.D.
• Samantha Marek, CP
• Mark a. Ligocki, DDS, PC. (Ligocki Dental Group)
• Maria Marrero, APN
• Rachel Marie Marshall, DOT, OTR/L

• Periodontics in Oakbrook Terrace, IL
• Providers in Oakbrook Terrace, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.