Individual provider Active NPI

George D Reskakis, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1679747356
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
035193 Issued in NY
Practice address
515 Madison Ave
Suite 3900
New York, NY 10022-5403
Phone
(212) 935-9300
Fax
(212) 644-2062
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 035193 NY Primary

Addresses

Primary practice location

515 Madison Ave
Suite 3900
New York, NY 10022-5403

Mailing address

515 Madison Ave
Suite 3900
New York, NY 10022-5403
Phone (212) 935-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20150623001143 NY Order and Referring Only - DentistPractitioner - Dentist 9638480262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035193NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Dental Group PC General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1679747356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE",
            "address_2": "SUITE 3900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225403",
            "telephone_number": "212-935-9300",
            "fax_number": "212-644-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE",
            "address_2": "SUITE 3900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225403",
            "telephone_number": "212-935-9300",
            "fax_number": "212-644-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESKAKIS",
        "first_name": "GEORGE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.