Provider Demographics
NPI:1881325777
Name:PAPADOPOULOS, DEENA N (DMD)
Entity type:Individual
Prefix:DR
First Name:DEENA
Middle Name:N
Last Name:PAPADOPOULOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2887
Mailing Address - Country:US
Mailing Address - Phone:610-241-6703
Mailing Address - Fax:
Practice Address - Street 1:12 GENERAL WARREN BLVD STE 400
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1256
Practice Address - Country:US
Practice Address - Phone:484-673-0400
Practice Address - Fax:484-673-0401
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043738122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist