Philip John Vassilopoulos, D.D.S., D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

63089 Issued in CA

Practice address

2202 Camino Ramon
San Ramon, CA 94583-1328

Phone

(925) 830-9800

Fax

(925) 830-9801

NPI assigned

Apr 10, 2007

Last updated

Sep 24, 2021By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 24, 2016 through May 24, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deepthy Thomas, DDS, Inc.

  dba Reflections Dental Spa

  • Periodontics
  • San Ramon, CA
  • NPI 1265908404
  NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1538382569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 CAMINO RAMON",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831328",
            "telephone_number": "925-830-9800",
            "fax_number": "925-830-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 CAMINO RAMON",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831328",
            "telephone_number": "925-830-9800",
            "fax_number": "925-830-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSILOPOULOS",
        "first_name": "PHILIP",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN16639",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "63089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1265908404",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylie Vang
• Ilaiana Vargas
• Brenda Vasquez
• Lisette G Vasquez
• Linda Vassallo, C.R.N.F.A.
• Parisa Vatanka, PHARM.D.
• Sruthi Vatsavai
• Sandra Vazquez
• Sai A Vedaraju
• Cassandra Vela

• Periodontics in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.