Provider Demographics
NPI:1346300399
Name:PATRINOS, DEMETRIOS C (DMD MD)
Entity Type:Individual
Prefix:
First Name:DEMETRIOS
Middle Name:C
Last Name:PATRINOS
Suffix:
Gender:M
Credentials:DMD MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2585 WASHINGTON RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241
Mailing Address - Country:US
Mailing Address - Phone:412-833-3331
Mailing Address - Fax:412-833-2485
Practice Address - Street 1:2585 WASHINGTON RD
Practice Address - Street 2:SUITE 111
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241
Practice Address - Country:US
Practice Address - Phone:412-833-3331
Practice Address - Fax:412-833-2485
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028322L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA951132OtherHIGHMARK
PA211882OtherUPMC
U75061Medicare UPIN
PA951132OtherHIGHMARK