Provider Demographics
NPI:1255461612
Name:FRANGADAKIS, KENNETH (DDS)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:FRANGADAKIS
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 1:10383 TORRE AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014
Mailing Address - Country:US
Mailing Address - Phone:408-257-3031
Mailing Address - Fax:408-257-5842
Practice Address - Street 1:10383 TORRE AVE
Practice Address - Street 2:SUITE I
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014
Practice Address - Country:US
Practice Address - Phone:408-257-3031
Practice Address - Fax:408-257-5842
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18976122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist