Elias George Koutros, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS103262 Issued in CA

Practice address

1970 University Ave Ste 316
Riverside, CA 92507-5202

Phone

(951) 213-3460

Fax

(951) 213-3449

NPI assigned

Sep 20, 2006

Last updated

Apr 21, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1730286188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ARBOR CLUB DR UNIT 106",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822607",
            "telephone_number": "401-261-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 UNIVERSITY AVE STE 316",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925075202",
            "telephone_number": "951-213-3460",
            "fax_number": "951-213-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTROS",
        "first_name": "ELIAS",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN02680",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS103262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naga Pattabhi Rama Sankar Kothapalli, MD
• Priyanka Kothia
• Richard Tsukasa Kotomori, M.D.
• Melissa Holly Kotzin, MS
• Jafar Koupaie, MD
• Cory E Kowalski, PHD
• Jocelyn J Kraft
• Joseph Adam Kraft, DO
• Marlena Rapan Kraig, LMFT
• Kramer and Nguyen Dental Corporation (Riverside Plaza Dentistry Dental Group)

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.