Gus J. Livaditis, D.D.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

5052 Issued in MD

Practice address

1206 York Rd
Suite 100
Lutherville, MD 21093-6217

Phone

(410) 337-8950

Fax

(410) 337-8994

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700962610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 YORK RD",
            "address_2": "SUITE 100",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936217",
            "telephone_number": "410-337-8950",
            "fax_number": "410-337-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 YORK RD",
            "address_2": "SUITE 100",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936217",
            "telephone_number": "410-337-8950",
            "fax_number": "410-337-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVADITIS",
        "first_name": "GUS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "5052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Prosthodontics in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.