Provider Demographics
NPI:1295962710
Name:SISMANIS, DIMITRIOS N (MD)
Entity type:Individual
Prefix:
First Name:DIMITRIOS
Middle Name:N
Last Name:SISMANIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1630 WILKES RIDGE PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7460
Mailing Address - Country:US
Mailing Address - Phone:804-934-9344
Mailing Address - Fax:804-934-9034
Practice Address - Street 1:1630 WILKES RIDGE PKWY STE 102
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7460
Practice Address - Country:US
Practice Address - Phone:804-934-9344
Practice Address - Fax:804-934-9034
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101258198207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery