Individual provider Active NPI

George Xenakis, DDS, MS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1407045594
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042180 Issued in NY
Practice address
25 W 18TH St FL 4
New York, NY 10011-4676
Phone
(212) 388-2021
Fax
(212) 388-3156
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 042180 NY Primary

Addresses

Primary practice location

25 W 18TH St FL 4
New York, NY 10011-4676

Mailing address

145 E 15TH St Apt 6U
New York, NY 10003-3537
Phone (917) 374-5082

Other identifiers 1

IdentifierTypeStateIssuer
00244404OtherNYMEDICAID

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
Master of Science

State licenses

LicenseStateTypeSpecialty
042180NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1407045594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 15TH ST APT 6U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033537",
            "telephone_number": "917-374-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W 18TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114676",
            "telephone_number": "212-388-2021",
            "fax_number": "212-388-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XENAKIS",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "00244404",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.