Individual provider Active NPI

George Savas Douvas, DDSPHD

  • General Practice Dentistry
  • Idaho Springs, CO
National Provider Identifier
1861612129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6672 Issued in CO
Practice address
102 Spruce Lane
Idaho Springs, CO 80452
Phone
(303) 567-0840
Fax
(303) 567-0840
NPI assigned
Apr 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6672 CO Primary

Addresses

Primary practice location

102 Spruce Lane
Idaho Springs, CO 80452

Mailing address

102 Spruce Lane
PO. Box 420
Idaho Springs, CO 80452
Phone (303) 567-0840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160614001284 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648561191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6672COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
George S. Douvas D.D.S. PH.D. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861612129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SPRUCE LANE",
            "address_2": "PO. BOX 420",
            "city": "IDAHO SPRINGS",
            "state": "CO",
            "postal_code": "80452",
            "telephone_number": "303-567-0840",
            "fax_number": "303-567-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SPRUCE LANE",
            "city": "IDAHO SPRINGS",
            "state": "CO",
            "postal_code": "80452",
            "telephone_number": "303-567-0840",
            "fax_number": "303-567-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUVAS",
        "first_name": "GEORGE",
        "middle_name": "SAVAS",
        "name_prefix": "Dr.",
        "credential": "DDSPHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Springs, CO

Sources for this page

Verify at the official NPI Registry.