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General NPI Number Information
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NPI Number | 1376928580
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Entity Type | Organization
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Legal Business Name | GEORGE XENAKIS, DDS, FLUSHING, LLC
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 14409 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11354-4230
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Country | US
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Telephone | 718-878-5557
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Fax | 718-577-5380
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Provider Business Mailing Address
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Address Line | 34 W 32ND ST FL 11
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City | NEW YORK
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State | NY
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Zip | 10001-3838
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Country | US
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Telephone | 212-643-0927
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Fax | 646-655-0639
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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 | 212-643-0927
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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 | 042180
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License Number State | NY
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