Provider Demographics
NPI:1881614121
Name:PADOUSIS & KAMINARIS DDS PA
Entity type:Organization
Organization Name:PADOUSIS & KAMINARIS DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANTINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAMINARIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-866-6660
Mailing Address - Street 1:6304 KENWOOD AVENUE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237
Mailing Address - Country:US
Mailing Address - Phone:410-866-6660
Mailing Address - Fax:410-866-1557
Practice Address - Street 1:6304 KENWOOD AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237
Practice Address - Country:US
Practice Address - Phone:410-866-6660
Practice Address - Fax:410-866-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD130210OtherCIGNA HMO
MD588871OtherUNITED CONCORDIA
MD4976OtherCAREFIRST BCBS
MD19584OtherAETNA HMO