Provider Demographics
NPI:1104944016
Name:KARIDAS, ANNA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:KARIDAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 SUMMER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5546
Mailing Address - Country:US
Mailing Address - Phone:203-961-8140
Mailing Address - Fax:203-357-8479
Practice Address - Street 1:999 SUMMER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5546
Practice Address - Country:US
Practice Address - Phone:203-961-8140
Practice Address - Fax:203-357-8479
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT76311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice