Healthcare Provider Details

I. General information

NPI: 1851966451
Provider Name (Legal Business Name): VICTOR POPANDOPOULO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: VICTOR POPADOPOULOS DDS

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 N BEERS ST STE 2F
HOLMDEL NJ
07733-1512
US

IV. Provider business mailing address

723 N BEERS ST STE 2F
HOLMDEL NJ
07733-1512
US

V. Phone/Fax

Practice location:
  • Phone: 929-336-9470
  • Fax:
Mailing address:
  • Phone: 929-336-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number062394-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03114600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: