Mike Kostakos, Dds, P.C.

LBN: Mike Kostakos, Dds, P.C.
Mike Kostakos, Dds, P.C. is an health care organization with primary practice located at 20307 W 12 Mile Rd Ste 101 , Southfield MI 48076-5407. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Mike Kostakos, Dds, P.C. can be contacted via phone (248) 559-1220, or through Salama, Wala via phone (248) 559-1220.

Contact Information

Primary practice address
20307 W 12 Mile Rd Ste 101 Southfield MI 48076-5407
Phone: (248) 559-1220
Fax: (248) 559-4300
Website:
Map and Directions
Authorized official contact:
Name: Salama, Wala
Phone: (248) 559-1220

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1295441822
LBN Legal business name Mike Kostakos, Dds, P.C.
DBA Doing business as
Authorized official Salama, Wala
Entity Organization
Organization subpart 1 No
Enumeration date Jan 26th, 2023
Last updated Jan 26th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295441822 NPPES
Michigan MEDICAID 1700932241

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