Corey Mavromatis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401418210 Issued in VA

Practice address

2248 Sunstates CT Ste 103
Virginia Beach, VA 23451-1553

Phone

(757) 496-9123

NPI assigned

Mar 28, 2022

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

Practice roles

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.

• Jack Mavromatis DDS, LTD.

  • General Practice Dentistry
  • Virginia Beach, VA
  • NPI 1134273683
  NPD (past)
• Jack Mavromatis, DDS, LTD.

  dba a division of Atlantic Dental Care

  • Dentist
  • Virginia Beach, VA
  • NPI 1467798603
  NPD (past)

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1861142259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 SPRING ST APT D",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2248 SUNSTATES CT STE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511553",
            "telephone_number": "757-496-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVROMATIS",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-08-07",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Frank Maugeri Jr., DDS
• Micheal Maugeri, LPTA
• Anne Kathryn Maurer, D.C.
• Caroline Davis Maurette
• Carter Jack Mavromatis, DMD
• Jack Mavromatis, D.D.S.
• Komi Mawussi
• Maxim Healthcare Services
• Maxim Healthcare Services
• Maxim Healthcare Services Inc.

• General Practice Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.