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General NPI Number Information
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NPI Number | 1538166939
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Entity Type | Individual
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Provider Name | DIMITRIOS J VARELDZIS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 215 CENTER PARK DR STE 900
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City | KNOXVILLE
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State | TN
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Zip | 37922-2176
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Country | US
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Telephone | 865-966-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 215 CENTER PARK DR STE 900
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City | KNOXVILLE
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State | TN
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Zip | 37922-2176
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Country | US
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Telephone | 865-966-0500
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS0000011708
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D6471
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License Number State | OR
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