National Provider Identifier

Athena Diamandis, DMD

Athena Diamandis, DMD is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Brockport, NY and a listed phone number of (585) 637-3905.

NPI 1457505612Brockport, NYGeneral Practice Dentistry

Profile Overview

NPI
1457505612
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
November 13, 2008
Last Updated
November 13, 2008

Practice Location

  • 300 West Ave
  • Brockport, NY 14420-1118

Phone: (585) 637-3905

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1457505612
Entity Type
Individual
Last Name
Diamandis
First Name
Athena
Credential
DMD
Mailing Street Address
300 West Ave
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-1118
Mailing Country
US
Mailing Phone
(585) 637-3905
Mailing Fax
(585) 637-4990
Practice Street Address
300 West Ave
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1118
Practice Country
US
Practice Phone
(585) 637-3905
Practice Fax
(585) 637-4990
Enumeration Date
November 13, 2008
Last Updated
November 13, 2008
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)
Other Identifiers
161020913 (NY, Employer Tax Id)