Healthcare Provider Details

I. General information

NPI: 1407005846
Provider Name (Legal Business Name): CHRISTOS ANGELOPOULOS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 09/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W END AVE APT #10B
NEW YORK NY
10023-6349
US

IV. Provider business mailing address

101 W END AVE APT #10B
NEW YORK NY
10023-6349
US

V. Phone/Fax

Practice location:
  • Phone: 646-541-9183
  • Fax:
Mailing address:
  • Phone: 646-541-9183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License Number053464-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: