Active NPI
Fotinos Panagakos, D.M.D
- General Practice Dentistry
- Yakima, WA
National Provider Identifier
1780006130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DI18552
- Practice address
- 200 University Pkwy # 102
Yakima, WA 98901-9539 - Phone
- (908) 499-1332
- NPI assigned
- Jan 19, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI18552 | NJ | Primary |
Addresses
Primary practice location
200 University Pkwy # 102
Yakima, WA 98901-9539
Mailing address
909 River Rd
Piscataway, NJ 08854-5503
Phone (908) 499-1332
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
| License | State | Type | Specialty |
|---|---|---|---|
| DI18552 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756598400000",
"number": "1780006130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 RIVER RD",
"city": "PISCATAWAY",
"state": "NJ",
"postal_code": "088545503",
"telephone_number": "908-499-1332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UNIVERSITY PKWY # 102",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989019539",
"telephone_number": "908-499-1332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANAGAKOS",
"first_name": "FOTINOS",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-19",
"last_updated": "2025-08-31",
"certification_date": "2025-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI18552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.