Provider Demographics
NPI:1922214097
Name:BAKOS, ILDIKO EYDIE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ILDIKO
Middle Name:EYDIE
Last Name:BAKOS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22255 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3964
Mailing Address - Country:US
Mailing Address - Phone:440-333-1007
Mailing Address - Fax:
Practice Address - Street 1:22255 CENTER RIDGE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3964
Practice Address - Country:US
Practice Address - Phone:440-333-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0186601223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics