Provider Demographics
NPI:1235206269
Name:SCANDALIOS, ARTEMIS CHRISTINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTEMIS
Middle Name:CHRISTINA
Last Name:SCANDALIOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 A COMPUTER DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609
Mailing Address - Country:US
Mailing Address - Phone:919-781-0056
Mailing Address - Fax:919-781-8253
Practice Address - Street 1:3803 A COMPUTER DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:919-781-0056
Practice Address - Fax:919-781-8253
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5954OtherDENTAL LICENSE STATE
NC899758AMedicaid
NC5954OtherDENTAL LICENSE STATE