Provider Demographics
NPI:1023130804
Name:FILANDRIANOS, THEODORE D (DMD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:D
Last Name:FILANDRIANOS
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 1:1400 CENTRE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2415
Mailing Address - Country:US
Mailing Address - Phone:617-244-4871
Mailing Address - Fax:617-965-9497
Practice Address - Street 1:1400 CENTRE ST STE 101
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2415
Practice Address - Country:US
Practice Address - Phone:617-244-4871
Practice Address - Fax:617-965-9497
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA149211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice