Provider Demographics
NPI:1366438988
Name:DEMOS, JOHN DIMITRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DIMITRIS
Last Name:DEMOS
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 1:1575 WOOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4091
Mailing Address - Country:US
Mailing Address - Phone:330-753-7735
Mailing Address - Fax:330-668-6570
Practice Address - Street 1:1575 WOOSTER AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4091
Practice Address - Country:US
Practice Address - Phone:330-753-7735
Practice Address - Fax:330-668-6570
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH191351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice