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General NPI Number Information
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NPI Number | 1306982889
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Entity Type | Individual
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Provider Name | ANGELA GERMANAKOS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14921 14TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357-1729
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Country | US
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Telephone | 718-746-1415
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Fax | 718-746-3082
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Provider Business Mailing Address
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Address Line | 436 BROADWAY
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City | BETHPAGE
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State | NY
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Zip | 11714-2817
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Country | US
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Telephone | 516-316-0935
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Fax | 718-746-3082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 434041
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License Number State | NY
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