Provider Demographics
NPI:1205857570
Name:YIANNIOS, NICHOLAS CHRIST (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:CHRIST
Last Name:YIANNIOS
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 1:3718 S PINNACLE HILLS PKWY
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8897
Mailing Address - Country:US
Mailing Address - Phone:479-876-8000
Mailing Address - Fax:479-876-8878
Practice Address - Street 1:3718 S PINNACLE HILLS PKWY
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8897
Practice Address - Country:US
Practice Address - Phone:479-876-8000
Practice Address - Fax:479-876-8878
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2015-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0156801223G0001X
AR39791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice