Active NPI
Aristeidis Panagiotou
- Orthodontics and Dentofacial Orthopedics Dentistry
- Rockford, IL
National Provider Identifier
1477262327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 019.034009
- Practice address
- 5051 E State St
Rockford, IL 61108-2310 - Phone
- (815) 918-4427
- NPI assigned
- Nov 18, 2022
- Last updated
- Nov 18, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 019.034009 | IL | Primary |
Addresses
Primary practice location
5051 E State St
Rockford, IL 61108-2310
Mailing address
90 Glendon PL Unit F
Williamsville, NY 14221-6085
Phone (585) 635-8640
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 |
|---|---|---|---|
| 019.034009 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1477262327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 GLENDON PL UNIT F",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142216085",
"telephone_number": "585-635-8640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5051 E STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082310",
"telephone_number": "815-918-4427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANAGIOTOU",
"first_name": "ARISTEIDIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-18",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "019.034009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.