MEDICARE: DEMETRIOS BAYIOKOS, DMD, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DI 18606	NJ

General Provider Information

NPI Number	:	1932320371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEMETRIOS BAYIOKOS, DMD, LLC.

Provider Business Mailing Address
First Line	:	415 WEST ST
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5010
Country	:	US
Telephone Number	:	201-944-8305
Fax Number	:	201-944-9491

Provider Business Practice Location Address
First Line	:	415 WEST ST
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5010
Country	:	US
Telephone Number	:	201-944-8305
Fax Number	:	201-944-9491

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DEMETRIOS BAYIOKOS
Credential	:	D.M.D.
Telephone Number	:	201-944-8305

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	08/22/2020

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