Aristides Koutsoubis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

063408 Issued in NY

Practice address

56 The Cir
East Hampton, NY 11937-2725

Phone

(844) 735-8863

NPI assigned

Jun 10, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1447989769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 BODANYI PL",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796531",
            "telephone_number": "631-576-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 THE CIR",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119372725",
            "telephone_number": "844-735-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTSOUBIS",
        "first_name": "ARISTIDES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Charles Kavanaugh, D.C.
• Nancy Patricia Keegan
• Chris Choi Keizerstein
• Valerie King, PH.D.
• Kinga Koreh, MD
• Michael Jeffrey Kramer, M.D.
• David Christopher Lado, M.D.
• Sharyn Lawall
• Colin Lee
• Susan Lemonier, M.S., CCC-SLP,A

• Dentist in East Hampton, NY
• Providers in East Hampton, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.