Provider Demographics
NPI:1740663590
Name:SOLDATOS, NIKOLAOS (DDS, MSD, PHD)
Entity type:Individual
Prefix:PROF
First Name:NIKOLAOS
Middle Name:
Last Name:SOLDATOS
Suffix:
Gender:M
Credentials:DDS, MSD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 CAMBRIDGE ST STE 6470
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2032
Mailing Address - Country:US
Mailing Address - Phone:713-486-4444
Mailing Address - Fax:
Practice Address - Street 1:7500 CAMBRIDGE ST STE 6470
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-486-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX317311223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
N/AOtherI WILL HAVE MEDCAID UNDER UNIVERSITY OF COLORADO, SCHOOL OF DENTAL MEDICINE