Provider Demographics
NPI:1124143698
Name:MAKRIDES, NICHOLAS STELIOS (DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:STELIOS
Last Name:MAKRIDES
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6948 TRUMPETER SWAN LN
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-3294
Mailing Address - Country:US
Mailing Address - Phone:202-353-4728
Mailing Address - Fax:
Practice Address - Street 1:320 1ST ST NW
Practice Address - Street 2:HOLC BLDG, ROOM 1000
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20534-0002
Practice Address - Country:US
Practice Address - Phone:202-353-4728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174941223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health