MEDICARE: DR. DEMETRIOS BAYIOKOS D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DI 18606	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881815223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEMETRIOS BAYIOKOS D.M.D.

Provider Business Mailing Address
First Line	:	415 WEST ST
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5010
Country	:	US
Telephone Number	:	201-944-8305
Fax Number	:	201-944-9491

Provider Business Practice Location Address
First Line	:	415 WEST ST
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5010
Country	:	US
Telephone Number	:	201-944-8305
Fax Number	:	201-944-9491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/09/2007

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