Provider Demographics
NPI:1700031739
Name:VENIZELOS, CHRISTINA GIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:GIKA
Last Name:VENIZELOS
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 1:2211 CROCKER ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145
Mailing Address - Country:US
Mailing Address - Phone:440-835-6220
Mailing Address - Fax:440-835-6220
Practice Address - Street 1:2211 CROCKER ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-835-6220
Practice Address - Fax:440-835-6220
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300171951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice