Provider Demographics
NPI:1720200454
Name:KOKINIAS, DEAN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:J
Last Name:KOKINIAS
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 1:6085 STRATHMOOR DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6635
Mailing Address - Country:US
Mailing Address - Phone:815-398-5550
Mailing Address - Fax:815-398-5920
Practice Address - Street 1:6085 STRATHMOOR DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6635
Practice Address - Country:US
Practice Address - Phone:815-398-5550
Practice Address - Fax:815-398-5920
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL221281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice