Provider Demographics
NPI:1063468197
Name:ANDREADIS, GEORGE T (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:T
Last Name:ANDREADIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9120 WHISTLING SWAN RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-8902
Mailing Address - Country:US
Mailing Address - Phone:804-796-3913
Mailing Address - Fax:
Practice Address - Street 1:6425 CHESTERFIELD MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-8810
Practice Address - Country:US
Practice Address - Phone:804-796-9500
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0055451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice