Provider Demographics
NPI:1174642847
Name:SENGOS, DEMETRIOS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEMETRIOS
Middle Name:
Last Name:SENGOS
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 1:45 W 10TH ST
Mailing Address - Street 2:SUITE LE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8763
Mailing Address - Country:US
Mailing Address - Phone:212-982-5883
Mailing Address - Fax:212-982-2901
Practice Address - Street 1:45 W 10TH ST
Practice Address - Street 2:SUITE LE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8763
Practice Address - Country:US
Practice Address - Phone:212-982-5883
Practice Address - Fax:212-982-2901
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038824122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist