Provider Demographics
NPI:1225219819
Name:CONSTANTIN, SERIOJA (DDS)
Entity Type:Individual
Prefix:
First Name:SERIOJA
Middle Name:
Last Name:CONSTANTIN
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 1:8 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3413
Mailing Address - Country:US
Mailing Address - Phone:914-238-8552
Mailing Address - Fax:914-238-8782
Practice Address - Street 1:8 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3413
Practice Address - Country:US
Practice Address - Phone:914-238-8552
Practice Address - Fax:914-238-8782
Is Sole Proprietor?:No
Enumeration Date:2007-11-24
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0479511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice