Provider Demographics
NPI:1942721998
Name:ASIMAKOPOULOS, LOUIS DAVID (DMD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:DAVID
Last Name:ASIMAKOPOULOS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7624 BLACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2331
Mailing Address - Country:US
Mailing Address - Phone:630-373-6024
Mailing Address - Fax:
Practice Address - Street 1:3941 75TH ST STE 103
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7300
Practice Address - Country:US
Practice Address - Phone:630-375-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.031125122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist