Provider Demographics
NPI:1770622995
Name:CORKOS, ARIS (DDS)
Entity type:Individual
Prefix:DR
First Name:ARIS
Middle Name:
Last Name:CORKOS
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 1:3878 W CARSON ST
Mailing Address - Street 2:STE 200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6707
Mailing Address - Country:US
Mailing Address - Phone:310-316-6062
Mailing Address - Fax:310-316-4782
Practice Address - Street 1:21320 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5606
Practice Address - Country:US
Practice Address - Phone:310-701-7412
Practice Address - Fax:310-316-4782
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADU315901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice