Provider Demographics
NPI:1609885029
Name:TATAKIS, WEI REN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WEI
Middle Name:REN
Last Name:TATAKIS
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 1:3200 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1725
Mailing Address - Country:US
Mailing Address - Phone:614-488-6369
Mailing Address - Fax:
Practice Address - Street 1:3200 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-1725
Practice Address - Country:US
Practice Address - Phone:614-488-6369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH214821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice