Provider Demographics
NPI:1619111333
Name:HELIDONAS, IOANNIS J (DDS)
Entity Type:Individual
Prefix:DR
First Name:IOANNIS
Middle Name:J
Last Name:HELIDONAS
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 1:7200-2 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6950
Mailing Address - Country:US
Mailing Address - Phone:727-849-5258
Mailing Address - Fax:727-847-5306
Practice Address - Street 1:7200-2 RIDGE RD
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6950
Practice Address - Country:US
Practice Address - Phone:727-849-5258
Practice Address - Fax:727-847-5306
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17754122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist