Provider Demographics
NPI:1396121489
Name:EMMANOUIL, KALYOPY N (DDS)
Entity type:Individual
Prefix:
First Name:KALYOPY
Middle Name:N
Last Name:EMMANOUIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 SPRINGROCK LN # II
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4375
Mailing Address - Country:US
Mailing Address - Phone:281-701-6074
Mailing Address - Fax:
Practice Address - Street 1:1470 SPRINGROCK LN # II
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4375
Practice Address - Country:US
Practice Address - Phone:281-701-6074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31243122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist