Provider Demographics
NPI:1770815763
Name:VAFIADIS, DEAN CONSTANTINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:CONSTANTINE
Last Name:VAFIADIS
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 1:693 5TH AVE
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3110
Mailing Address - Country:US
Mailing Address - Phone:212-813-1555
Mailing Address - Fax:
Practice Address - Street 1:693 5TH AVE
Practice Address - Street 2:14TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3110
Practice Address - Country:US
Practice Address - Phone:212-813-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYDN0425261223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics