Athanasios Nicolozakes, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019.033194 Issued in IL

Practice address

4560 W 103Rd St
Oak Lawn, IL 60453-4869

Phone

(708) 423-5155

NPI assigned

Apr 20, 2021

Last updated

Aug 22, 2022By 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

Enrolled in IL

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1578144556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 W 103RD ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534869",
            "telephone_number": "708-423-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 W 103RD ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534869",
            "telephone_number": "708-423-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1144 Lake St Ste 213",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603011043",
            "country_code": "US",
            "telephone_number": "708-295-3243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLOZAKES",
        "first_name": "ATHANASIOS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "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": "IL",
            "license": "019.033194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Nezon
• Munachiso Amanda Ngene, MD, MPH
• Dzung X Nguyen, OD
• Michelle Nguyen
• Peter Nguyen, M.D.
• Eileen Niemiera, PHD. LC.P.C.
• Helen A. Nikolas, M.D.
• Maria Nicole Nilsson, M.S.N, A.P.N-BC
• Mark R Nitekman, MD
• Anne Nixon-Hammoudeh

• Dentist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.