Vasilios A Kostakis, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

059920 Issued in NY

Practice address

6070 Woodhaven Blvd Ste C2
Elmhurst, NY 11373-5545

Phone

(718) 897-6400

Fax

(718) 997-9710

NPI assigned

Jan 27, 2014

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 13, 2021 through May 13, 2027

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.

• Asnis Dental, PLLC

  • Dentist
  • Lynbrook, NY
  • NPI 1437623378
  NPD (past)

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1861815888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 WOODHAVEN BLVD STE C2",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735545",
            "telephone_number": "718-897-6400",
            "fax_number": "718-997-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 WOODHAVEN BLVD STE C2",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735545",
            "telephone_number": "718-897-6400",
            "fax_number": "718-997-9710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_2": "DIVISION OF ORAL AND MAXILLOFACIAL SURGERY",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "718-470-7113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTAKIS",
        "first_name": "VASILIOS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "059920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquilyn Boling Kondo, PT
• Main Sen Koo
• William K. Kopp, D.D.S.
• Kristina C Kordesch, NP
• Kayla Korff, RD, CDN
• Rudra Pradeep Koul, MD
• Richard Kranjac, LCSW
• Peter S Kratka, M.D.
• Kelly Anne Kress, R.PH.
• Krishna K Jhaveri Physician PC

• Oral and Maxillofacial Surgery (Dentist) in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.