Provider Demographics
NPI:1598740789
Name:VARTHOLOMEOS, MARIA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:VARTHOLOMEOS
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 1:15005 21 AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2306
Mailing Address - Country:US
Mailing Address - Phone:718-353-5853
Mailing Address - Fax:718-353-5947
Practice Address - Street 1:15005 21 AVE
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-2306
Practice Address - Country:US
Practice Address - Phone:718-353-5853
Practice Address - Fax:718-353-5947
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047509122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist