Provider Demographics
NPI:1922062546
Name:KARDELIS, ANTHONY C (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:C
Last Name:KARDELIS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:7373 W JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2021
Mailing Address - Country:US
Mailing Address - Phone:303-986-2765
Mailing Address - Fax:303-986-2767
Practice Address - Street 1:7373 W JEFFERSON AVE
Practice Address - Street 2:#404
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2038
Practice Address - Country:US
Practice Address - Phone:303-986-2765
Practice Address - Fax:303-986-2767
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84181223E0200X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223E0200XDental ProvidersDentistEndodontics
Not Answered1223P0300XDental ProvidersDentistPeriodontics