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General NPI Number Information
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NPI Number | 1346610623
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Entity Type | Individual
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Provider Name | IOANNIS BITSIS DDS
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Gender | Male
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 13160 MINDANAO WAY STE 170
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6393
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Country | US
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Telephone | 310-823-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 5TH ST APT 208
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City | SANTA MONICA
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State | CA
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Zip | 90401-1493
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Country | US
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Telephone | 206-839-6318
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DE60536003
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DDS106119
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License Number State | CA
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