Provider Demographics
NPI:1407005846
Name:ANGELOPOULOS, CHRISTOS (DDS)
Entity type:Individual
Prefix:PROF
First Name:CHRISTOS
Middle Name:
Last Name:ANGELOPOULOS
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 1:101 W END AVE
Mailing Address - Street 2:APT #10B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6349
Mailing Address - Country:US
Mailing Address - Phone:646-541-9183
Mailing Address - Fax:
Practice Address - Street 1:101 W END AVE
Practice Address - Street 2:APT #10B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6349
Practice Address - Country:US
Practice Address - Phone:646-541-9183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053464-11223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology