Provider Demographics
NPI:1629072418
Name:SAKOS, DEANO A (DDS)
Entity Type:Individual
Prefix:
First Name:DEANO
Middle Name:A
Last Name:SAKOS
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 1:515 S CAPITAL OF TEXAS HWY
Mailing Address - Street 2:STE 220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-4305
Mailing Address - Country:US
Mailing Address - Phone:512-327-8645
Mailing Address - Fax:512-306-0871
Practice Address - Street 1:515 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:STE 220
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-4305
Practice Address - Country:US
Practice Address - Phone:512-327-8645
Practice Address - Fax:512-306-0871
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice