Healthcare Provider Details

I. General information

NPI: 1427792852
Provider Name (Legal Business Name): MARINA KLAPPAS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARINA PAPADOPOULOS

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HILLSIDE AVE STE C
WILLISTON PARK NY
11596-2311
US

IV. Provider business mailing address

2368 26TH ST
ASTORIA NY
11105-3119
US

V. Phone/Fax

Practice location:
  • Phone: 516-742-2820
  • Fax:
Mailing address:
  • Phone: 347-241-4457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number063415
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: