Provider Demographics
NPI:1669578100
Name:MICHAEL A. PIKOS, D.D.S., P.A.
Entity type:Organization
Organization Name:MICHAEL A. PIKOS, D.D.S., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRISIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIKOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-786-1631
Mailing Address - Street 1:2711 TAMPA RD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3312
Mailing Address - Country:US
Mailing Address - Phone:727-786-1631
Mailing Address - Fax:727-785-8477
Practice Address - Street 1:2711 TAMPA RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3312
Practice Address - Country:US
Practice Address - Phone:727-786-1631
Practice Address - Fax:727-785-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24953Medicare ID - Type UnspecifiedPALM HARBOR OFFICE