Provider Demographics
NPI:1225262884
Name:KARYDIS, ANASTASIOS (DDS, MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:ANASTASIOS
Middle Name:
Last Name:KARYDIS
Suffix:
Gender:M
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 UNION AVE
Mailing Address - Street 2:C511
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3513
Mailing Address - Country:US
Mailing Address - Phone:901-448-6279
Mailing Address - Fax:901-448-1390
Practice Address - Street 1:875 UNION AVE
Practice Address - Street 2:C511
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3513
Practice Address - Country:US
Practice Address - Phone:901-448-6279
Practice Address - Fax:901-448-1390
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS88851223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics