Individual provider Active NPI

Evlambia Hajishengallis, DDS

  • Pediatric Dentistry
  • Louisville, KY
National Provider Identifier
1639259815
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8311 Issued in KY
Practice address
501 S Preston St
Louisville, KY 40292-0001
Phone
(502) 852-5128
Fax
(502) 852-7163
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 8311 KY Primary

Addresses

Primary practice location

501 S Preston St
Louisville, KY 40292-0001

Mailing address

501 S Preston St
Louisville, KY 40292-0001
Phone (502) 852-5128

Other identifiers 2

IdentifierTypeStateIssuer
7100019150MedicaidKY
9181422OtherKYDORAL DENTAL

Other names 1

  • Dr. Evlambia Harokopakis Former name

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

LicenseStateTypeSpecialty
8311KYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1639259815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S PRESTON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402920001",
            "telephone_number": "502-852-5128",
            "fax_number": "502-852-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S PRESTON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402920001",
            "telephone_number": "502-852-5128",
            "fax_number": "502-852-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJISHENGALLIS",
        "first_name": "EVLAMBIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "8311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100019150",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "9181422",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVLAMBIA",
            "last_name": "HAROKOPAKIS",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.