Provider Demographics
NPI:1659585941
Name:ANGELAKIS, DESPINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:DESPINA
Middle Name:
Last Name:ANGELAKIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 THREE ISLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2888
Mailing Address - Country:US
Mailing Address - Phone:954-457-0697
Mailing Address - Fax:
Practice Address - Street 1:600 THREE ISLANDS BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2888
Practice Address - Country:US
Practice Address - Phone:954-457-0697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice