Provider Demographics
NPI:1821688862
Name:SOFOS, STAVROS JACQUES (DDS, MS)
Entity type:Individual
Prefix:
First Name:STAVROS
Middle Name:JACQUES
Last Name:SOFOS
Suffix:
Gender:
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10110 WOODLANDS PKWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2927
Mailing Address - Country:US
Mailing Address - Phone:713-576-5133
Mailing Address - Fax:
Practice Address - Street 1:10110 WOODLANDS PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2927
Practice Address - Country:US
Practice Address - Phone:713-576-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014186611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics