Xenakis, Mark
Xenakis, Mark is an individual health care provider with primary practice located at 80 20 Broadway Suite 1 M, Elmhurst NY 11373. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Xenakis, Mark can be contacted via phone (718) 779-1772.Contact Information
Primary practice address
80 20 Broadway Suite 1 M
Elmhurst NY 11373
Phone: (718) 779-1772
Fax: (718) 779-1772
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 044460 | New York |
Profile Details
| NPI number | 1093787954 |
|---|---|
| LBN Legal business name | Xenakis, Mark |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093787954 | NPPES |
| New York | MEDICAID | 01532269 |
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