Individual provider Active NPI

Sofia M Fokas, D.D.S. PC

  • General Practice Dentistry
  • Hicksville, NY
National Provider Identifier
1861600371
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049894 Issued in NY
Practice address
25 Holyoke Rd
Hicksville, NY 11801-3447
Phone
(516) 605-0011
Fax
(516) 605-0730
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049894 NY Primary

Addresses

Primary practice location

25 Holyoke Rd
Hicksville, NY 11801-3447

Mailing address

25 Holyoke Road
Hicksville, NY 11801-3447
Phone (516) 605-0011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160216001824 NY Order and Referring Only - DentistPractitioner - Dentist 9133424955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049894NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1861600371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HOLYOKE ROAD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013447",
            "telephone_number": "516-605-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HOLYOKE RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013447",
            "telephone_number": "516-605-0011",
            "fax_number": "516-605-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOKAS",
        "first_name": "SOFIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S. PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.