Provider Demographics
NPI:1932250701
Name:MIHALIOS, CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:MIHALIOS
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 1:4221 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE M100
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361
Mailing Address - Country:US
Mailing Address - Phone:718-279-8202
Mailing Address - Fax:718-279-8205
Practice Address - Street 1:4221 FRANCIS LEWIS BLVD.
Practice Address - Street 2:SUITE M100
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361
Practice Address - Country:US
Practice Address - Phone:718-279-8202
Practice Address - Fax:718-279-8205
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0524181122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist