John Constantinidis

Primary specialty

DentistTaxonomy code 122300000X

License

063876 Issued in NY

Practice address

160 Middle Rd Ste 4
Sayville, NY 11782-3126

Phone

(631) 589-5554

NPI assigned

Feb 9, 2022

Last updated

Feb 12, 2025By the provider in NPPES

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": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1497409460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034017",
            "telephone_number": "516-382-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MIDDLE RD STE 4",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823126",
            "telephone_number": "631-589-5554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Westchester Hall",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-2557",
            "fax_number": "631-444-6013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20417 35th Ave",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113611243",
            "country_code": "US",
            "telephone_number": "516-980-5724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONSTANTINIDIS",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-09",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063876",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Sayville, NY
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.