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Contact Information

DEAN P KOSTAKOS, DPM
1380 UPPER HEMBREE RD
ROSWELL, GA30076-1146
 Phone: 770-346-7500
 Fax: 770-346-8800
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for DEAN P KOSTAKOS · (Male)

NPI Number 1417056847
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 09/22/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Yes
Identifiers
  • GA License # POD000605
  • Other 4407320 AETNA HEALTH PLANS
  • Other P00166113 RAIL ROAD MEDICARE
  • GA Other 909671 BLUE CROSS BLUE SHIELD
  • GA Other U28228 COVENTRY
Hospital affiliation(s)
  • NORTH FULTON REGIONAL HOSPITAL - (Acute Care)
    3000 HOSPITAL BOULEVARD
    ROSWELL, GA 30076
  • NORTHSIDE HOSPITAL - (Acute Care)
    1000 JOHNSON FERRY ROAD, NE
    ATLANTA, GA 30342
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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