NPIMap

Organization Active NPI

George Kourakin DMD, PA

Doing business as My Dentist

  • General Practice Dentistry
  • Millville, NJ
National Provider Identifier
1760530943
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D13065 Issued in NJ
Legal business name
GEORGE KOURAKIN DMD, PA
Doing business as
My Dentist
Practice address
16 W Vine St
Millville, NJ 08332-3823
Phone
(856) 825-0618
Fax
(856) 825-3420
NPI assigned
Jan 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. George Georgi Kourakin, D.M.D.NPI 1215041629
Title
Owner
Phone
(856) 825-0618

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D13065 NJ Primary

Addresses

Primary practice location

16 W Vine St
Millville, NJ 08332-3823

Mailing address

16 W Vine St
Millville, NJ 08332-3823
Phone (856) 825-0618

Other names 1

  • My Dentist Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760530943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 W VINE ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083323823",
            "telephone_number": "856-825-0618",
            "fax_number": "856-825-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 W VINE ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083323823",
            "telephone_number": "856-825-0618",
            "fax_number": "856-825-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE KOURAKIN DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOURAKIN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "GEORGI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-825-0618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "D13065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.