Provider Demographics
NPI:1245904366
Name:KOKORELIS, STEVE HARRY (DDS)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:HARRY
Last Name:KOKORELIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 N CHARLES ST APT 212
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5657
Mailing Address - Country:US
Mailing Address - Phone:804-426-7880
Mailing Address - Fax:
Practice Address - Street 1:9010 HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-4033
Practice Address - Country:US
Practice Address - Phone:410-665-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist