Provider Demographics
NPI:1508886847
Name:KAMINARIS, CONSTANTINE J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:J
Last Name:KAMINARIS
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 1:6304 KENWOOD AVENUE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237
Mailing Address - Country:US
Mailing Address - Phone:410-866-6660
Mailing Address - Fax:410-866-1557
Practice Address - Street 1:6304 KENWOOD AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237
Practice Address - Country:US
Practice Address - Phone:410-866-6660
Practice Address - Fax:410-866-1557
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4997122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD19584OtherAETNA HMO
MD588871OtherUNITED CONCORDIA
MD103021OtherCIGNA HMO
MD4976OtherCAREFIRST BCBS