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DR. ATHAS NICHOLAS KOMETAS DMD
NPI 1063663722
Dentist - General Practice in Daytona Beach Shores, FL

Active since September 30, 2008Opted out of Medicare · through Oct 4, 2026
3162 S ATLANTIC AVE, SUITE C, DAYTONA BEACH SHORES, FL 32118(386) 760-0030(386) 788-3873 Get Directions Write a Review

NPPES record last updated: September 30, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Athas Nicholas Kometas Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ATHAS NICHOLAS KOMETAS DMD (NPI 1063663722) is an individual general practice provider in Daytona Beach Shores, Florida, licensed in Florida (DN11431) and active in the NPI registry since September 2008. He has opted out of Medicare through October 4, 2026.

NPPES Registry Identity

NPI1063663722
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. ATHAS NICHOLAS KOMETASCredential: DMD
Location Address3162 S ATLANTIC AVE, SUITE CDaytona Beach Shores, FL 32118-6286
Mailing Address3162 S Atlantic Ave, Suite CDaytona Beach Shores, FL 32118-6286 · (386) 760-0030 · Fax (386) 788-3873
Phone(386) 760-0030
Fax(386) 788-3873
Sole ProprietorYes
Enumeration DateSeptember 30, 2008
✔ NPI 1063663722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in FL · DN11431
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3162 S ATLANTIC AVE, Daytona Beach Shores, FL 32118
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Athas Nicholas Kometas Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 4, 2022 through October 4, 2026.

Opt-Out Effective DateOctober 4, 2022
Opt-Out In Effect ThroughOctober 4, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Athas Kometas's NPI number?

The NPI number for Athas Kometas is 1063663722. It was assigned to this individual provider in the NPPES registry on September 30, 2008.

Where is Athas Kometas located?

Athas Kometas practices at 3162 S Atlantic Ave Suite C, Daytona Beach Shores, FL 32118. The listed phone number is (386) 760-0030.

What is Athas Kometas's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Athas Kometas enrolled in Medicare?

No. Athas Kometas has opted out of Medicare through October 4, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Athas Kometas was last updated on September 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.