Provider Demographics
NPI:1053849208
Name:ANDRONIKOU, KYRIACOS (DDS)
Entity Type:Individual
Prefix:MR
First Name:KYRIACOS
Middle Name:
Last Name:ANDRONIKOU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 WASHINGTON RD STE 303
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3279
Mailing Address - Country:US
Mailing Address - Phone:724-942-5630
Mailing Address - Fax:724-942-5632
Practice Address - Street 1:3055 WASHINGTON RD STE 303
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3279
Practice Address - Country:US
Practice Address - Phone:724-942-5630
Practice Address - Fax:724-942-5632
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2019-06-06
Deactivation Date:2018-01-05
Deactivation Code:
Reactivation Date:2018-02-13
Provider Licenses
StateLicense IDTaxonomies
PADS0412001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice