George Chris Panos, D.D.S.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

3806-015 Issued in WI

Practice address

N 67 W 31027 Club Circle East
Hartland, WI 53029

Phone

(126) 236-4744

NPI assigned

May 29, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407057441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N 67 W 31027 CLUB CIRCLE EAST",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "53029",
            "telephone_number": "126-236-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N 67 W 31027 CLUB CIRCLE EAST",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "53029",
            "telephone_number": "126-236-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOS",
        "first_name": "GEORGE",
        "middle_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "WI",
            "license": "3806-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly L.M. Newman, D.D.S.
• North Lake Family Dentistry
• Lindsay Oksiuta, PT
• Jeanne L Pallagi, MD
• Margaret M Pankow, RN, IBCLC, CLC
• Leda Patrick, RN
• Perfect Touch Chiropractic, LLC
• Rachel Marie Pfeifer, LPC, MS
• Kathleen M Phelan, M.D.
• Stefanie L Pipia, R.N.

• All providers in Hartland, WI
• Oral and Maxillofacial Pathology Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.