Provider Demographics
NPI:1093029571
Name:MARKOGIANNAKIS, DESPINA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:DESPINA
Middle Name:M
Last Name:MARKOGIANNAKIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 WISCONSIN AVE
Mailing Address - Street 2:SUITE 835
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6901
Mailing Address - Country:US
Mailing Address - Phone:301-652-0656
Mailing Address - Fax:
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:SUITE 835
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6901
Practice Address - Country:US
Practice Address - Phone:301-652-0656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10009141223G0001X
MD15605122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice