Provider Demographics
NPI:1124214762
Name:BELEGRATIS, TASOS A (DDS)
Entity Type:Individual
Prefix:
First Name:TASOS
Middle Name:A
Last Name:BELEGRATIS
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 1:7000 E BELLEVIEW AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1622
Mailing Address - Country:US
Mailing Address - Phone:303-773-0960
Mailing Address - Fax:303-773-9109
Practice Address - Street 1:7000 E BELLEVIEW AVE STE 205
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1622
Practice Address - Country:US
Practice Address - Phone:303-773-0960
Practice Address - Fax:303-773-9109
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9389122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist