Provider Demographics
NPI:1063505485
Name:HALIKIAS, JOHN R (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:HALIKIAS
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 1:2101 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5112
Mailing Address - Country:US
Mailing Address - Phone:718-891-4243
Mailing Address - Fax:718-891-7136
Practice Address - Street 1:2101 BROWN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5112
Practice Address - Country:US
Practice Address - Phone:718-891-4243
Practice Address - Fax:718-891-7136
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY395991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice