Constantina Bacopoulou, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010413 Issued in CT

Practice address

141 Franklin St
Stamford, CT 06901-1014

Phone

(203) 969-0802

Fax

(203) 357-0162

NPI assigned

Oct 11, 2007

Last updated

Feb 7, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1457549610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MAIN ST",
            "address_2": "ATTN: CREDENTIALING DPT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572718",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 FRANKLIN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069011014",
            "telephone_number": "203-969-0802",
            "fax_number": "203-357-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACOPOULOU",
        "first_name": "CONSTANTINA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010413",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236354",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soukaina Akil Ayoub, PHARMD
• B-IX Edgehill SNF LLC (Edgehill)
• Revekka Babayev
• Robert C Babkowski, MD
• Kristina Bacco, PT
• Anna M. Badini, PH.D.
• Raymond A Baer, MD
• Indrani Bagchi, BCBA
• Sayna Bagheri, MD
• Kenneth Arthur Bagwell, MD

• General Practice Dentistry in Stamford, CT
• Providers in Stamford, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.