Provider Demographics
NPI:1558434258
Name:KAVORINOS, ANTHONY D (DDS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:D
Last Name:KAVORINOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:D
Other - Last Name:KAVORINOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS APC
Mailing Address - Street 1:12604 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3508
Mailing Address - Country:US
Mailing Address - Phone:909-591-1745
Mailing Address - Fax:909-591-0885
Practice Address - Street 1:12604 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710
Practice Address - Country:US
Practice Address - Phone:909-591-1745
Practice Address - Fax:909-591-0885
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26439122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist