Provider Demographics
NPI:1669434767
Name:VLAHOS, YIANNIS A (DDS)
Entity type:Individual
Prefix:DR
First Name:YIANNIS
Middle Name:A
Last Name:VLAHOS
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 1:3200 LONE TREE WAY
Mailing Address - Street 2:#100
Mailing Address - City:ANITOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:925-754-2122
Mailing Address - Fax:925-754-2132
Practice Address - Street 1:3200 LONE TREE WAY
Practice Address - Street 2:#100
Practice Address - City:ANITOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-754-2122
Practice Address - Fax:925-754-2132
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24352122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist