Provider Demographics
NPI:1659883759
Name:PIKOS, ANTHONY MICHAEL (DMD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:PIKOS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 MISTY PLATEAU TRL
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1871
Mailing Address - Country:US
Mailing Address - Phone:727-420-5291
Mailing Address - Fax:
Practice Address - Street 1:2711 TAMPA RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3312
Practice Address - Country:US
Practice Address - Phone:727-786-1631
Practice Address - Fax:727-785-8477
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6470122300000X
FLDN230851223P0300X
FL23085122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty