Provider Demographics
NPI:1821880436
Name:PAPANTONIOU, DESSISLAVA NEYKOVA (MD)
Entity type:Individual
Prefix:
First Name:DESSISLAVA
Middle Name:NEYKOVA
Last Name:PAPANTONIOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PELLER RD
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-4543
Mailing Address - Country:US
Mailing Address - Phone:262-249-0221
Mailing Address - Fax:
Practice Address - Street 1:350 PELLER RD
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-4543
Practice Address - Country:US
Practice Address - Phone:262-249-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101497851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine