Provider Demographics
NPI:1316018138
Name:TRAKAKIS, GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:TRAKAKIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 FOX VALLEY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4116
Mailing Address - Country:US
Mailing Address - Phone:630-506-6721
Mailing Address - Fax:216-584-1007
Practice Address - Street 1:4405 FOX VALLEY CENTER DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4116
Practice Address - Country:US
Practice Address - Phone:630-506-6721
Practice Address - Fax:216-584-1007
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190223851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice