Active NPI
Irene Costaras-Vasilakis, DDS
- Dentist
- Parma, OH
National Provider Identifier
1386800480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15879
- Practice address
- 1440 Rockside Rd
Rockside Plaza #218
Parma, OH 44134-2774 - Phone
- (216) 749-4500
- Fax
- (216) 749-5975
- NPI assigned
- Jul 29, 2008
- Last updated
- Jul 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15879 | OH | Primary |
Addresses
Primary practice location
1440 Rockside Rd
Rockside Plaza #218
Parma, OH 44134-2774
Mailing address
1440 Rockside Rd
Rockside Plaza #218
Parma, OH 44134-2774
Phone (216) 749-4500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15879 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kontoveros Klobas Parma LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217289600000",
"number": "1386800480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 ROCKSIDE RD",
"address_2": "ROCKSIDE PLAZA #218",
"city": "PARMA",
"state": "OH",
"postal_code": "441342774",
"telephone_number": "216-749-4500",
"fax_number": "216-749-5975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 ROCKSIDE RD",
"address_2": "ROCKSIDE PLAZA #218",
"city": "PARMA",
"state": "OH",
"postal_code": "441342774",
"telephone_number": "216-749-4500",
"fax_number": "216-749-5975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTARAS-VASILAKIS",
"first_name": "IRENE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-29",
"last_updated": "2008-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "15879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parma, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.