George C Georgaklis

Primary specialty

DentistTaxonomy code 122300000X

License

DDS29051 Issued in CA

Practice address

4510 Executive Dr Ste 106
San Diego, CA 92121-3022

Phone

(858) 552-1223

NPI assigned

Sep 14, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• George C. Georgaklis DDS Apc

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1235295965
  NPD (past) Authorized official

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1932628591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213022",
            "telephone_number": "858-552-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213022",
            "telephone_number": "858-552-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGAKLIS",
        "first_name": "GEORGE",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "29051",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS29051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "29051",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "330114651",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naijah Ann Gentry
• Rebecca Sue Gentry, A.N.P.
• Genuine Psychological Services
• Genway Biotech, Inc. (GenWay Clinical Laboratory)
• Taryn Geolina
• George C. Georgaklis DDS Apc
• George Delgado M.D., Inc. (Culture of Life Family Health Care)
• George Sakoulas MD, Inc.
• George Xenakis, DDS, PC (U Dream Dental - San Diego)
• Alecia George

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.