Healthcare Provider Details

I. General information

NPI: 1104215664
Provider Name (Legal Business Name): GEORGE PLIAKAS, DDS, MS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CENTRAL PARK W
NEW YORK NY
10024-3020
US

IV. Provider business mailing address

271 CENTRAL PARK W
NEW YORK NY
10024-3020
US

V. Phone/Fax

Practice location:
  • Phone: 212-362-4400
  • Fax: 212-362-4403
Mailing address:
  • Phone: 212-362-4400
  • Fax: 212-362-4403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number096312
License Number StateNY

VIII. Authorized Official

Name: DR. GEORGE PLIAKAS
Title or Position: ORTHODONTIST/OWNER
Credential: DDS
Phone: 212-362-4400