Provider Demographics
NPI:1427436542
Name:GEORGE XENAKIS, DDS, 46TH STREET, LLC
Entity type:Organization
Organization Name:GEORGE XENAKIS, DDS, 46TH STREET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:XENAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDSS
Authorized Official - Phone:212-643-0927
Mailing Address - Street 1:34 W 32ND ST FL 11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3838
Mailing Address - Country:US
Mailing Address - Phone:212-643-0927
Mailing Address - Fax:646-655-0639
Practice Address - Street 1:4 E 46TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2406
Practice Address - Country:US
Practice Address - Phone:212-904-0300
Practice Address - Fax:646-358-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042180261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental