Provider Demographics
NPI:1003368119
Name:GREGORY K. KONTOPANOS, DDS & ASSOCIATES, PC
Entity Type:Organization
Organization Name:GREGORY K. KONTOPANOS, DDS & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:K
Authorized Official - Last Name:KONTOPANOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-275-7477
Mailing Address - Street 1:3525 IRON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-2937
Mailing Address - Country:US
Mailing Address - Phone:804-275-7477
Mailing Address - Fax:804-275-6313
Practice Address - Street 1:3525 IRON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-2937
Practice Address - Country:US
Practice Address - Phone:804-275-7477
Practice Address - Fax:804-275-6313
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010071321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty