Provider Demographics
NPI:1881615946
Name:DOKIANAKIS, STYLIANOS G (AUD)
Entity type:Individual
Prefix:DR
First Name:STYLIANOS
Middle Name:G
Last Name:DOKIANAKIS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:DR
Other - First Name:STELIOS
Other - Middle Name:G
Other - Last Name:DOKIANAKIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:399 E 32ND ST
Mailing Address - Street 2:HOLLAND AUDIOLOGY, PLLC
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-5518
Mailing Address - Country:US
Mailing Address - Phone:616-392-2222
Mailing Address - Fax:
Practice Address - Street 1:399 E 32ND ST
Practice Address - Street 2:HOLLAND AUDIOLOGY, PLLC
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-5518
Practice Address - Country:US
Practice Address - Phone:616-392-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000550231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1601000550OtherSTATE LICENSE
PA1617220OtherHIGHMARK
PAAT005850OtherSTATE LICENSE
PAAT005850OtherSTATE LICENSE
PA078582Medicare ID - Type Unspecified