Provider Demographics
NPI:1861600371
Name:FOKAS, SOFIA M (DDS PC)
Entity type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:M
Last Name:FOKAS
Suffix:
Gender:F
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HOLYOKE ROAD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3447
Mailing Address - Country:US
Mailing Address - Phone:516-605-0011
Mailing Address - Fax:
Practice Address - Street 1:25 HOLYOKE RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3447
Practice Address - Country:US
Practice Address - Phone:516-605-0011
Practice Address - Fax:516-605-0730
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0498941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice