Provider Demographics
NPI:1184358160
Name:IONUT, DAMARIS (DMD)
Entity type:Individual
Prefix:DR
First Name:DAMARIS
Middle Name:
Last Name:IONUT
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39393 VAN DYKE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-4636
Mailing Address - Country:US
Mailing Address - Phone:586-983-8015
Mailing Address - Fax:586-983-8018
Practice Address - Street 1:39393 VAN DYKE AVE STE 106
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-4636
Practice Address - Country:US
Practice Address - Phone:734-890-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016013091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice