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General NPI Number Information
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NPI Number | 1407045594
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Entity Type | Individual
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Provider Name | GEORGE XENAKIS DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 25 W 18TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10011-4676
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Country | US
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Telephone | 212-388-2021
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Fax | 212-388-3156
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Provider Business Mailing Address
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Address Line | 145 E 15TH ST APT 6U
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City | NEW YORK
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State | NY
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Zip | 10003-3537
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Country | US
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Telephone | 917-374-5082
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 042180
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License Number State | NY
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