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General NPI Number Information
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NPI Number | 1689050924
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Entity Type | Individual
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Provider Name | EVANTHIA PEIKIDIS DDS
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Gender | Female
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 1991 NEWBRIDGE RD
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City | BELLMORE
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State | NY
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Zip | 11710-2201
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Country | US
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Telephone | 516-360-0520
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Fax |
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Provider Business Mailing Address
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Address Line | 581 HULL ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-5028
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Country | US
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Telephone | 516-655-7154
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 057888
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License Number State | NY
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