Healthcare Provider Details

I. General information

NPI: 1134650971
Provider Name (Legal Business Name): ANASTASIA KATSAVOCHRISTOU DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 MAIN ST
BUFFALO NY
14214-3099
US

IV. Provider business mailing address

3435 MAIN ST
BUFFALO NY
14214-3099
US

V. Phone/Fax

Practice location:
  • Phone: 716-262-9750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number000084
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901021798
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number2901021798
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: