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General NPI Number Information
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NPI Number | 1013365535
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Entity Type | Organization
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Legal Business Name | GEORGE XENAKIS, DDS, PC
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 7808 CLAIREMONT MESA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92111-1613
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Country | US
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Telephone | 858-384-2822
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Fax | 858-384-2547
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Provider Business Mailing Address
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Address Line | 7808 CLAIREMONT MESA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92111-1613
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Country | US
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Telephone | 858-384-2822
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Fax | 858-384-2547
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE XENAKIS
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Credential | D.D.S
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Telephone | 917-374-5082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 64232
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License Number State | CA
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