Provider Demographics
NPI:1174398614
Name:LENA D KARKALAS DDS LTD
Entity type:Organization
Organization Name:LENA D KARKALAS DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KARKALAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:401-861-2140
Mailing Address - Street 1:151 WATERMAN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2118
Mailing Address - Country:US
Mailing Address - Phone:401-861-2140
Mailing Address - Fax:401-861-3010
Practice Address - Street 1:151 WATERMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2118
Practice Address - Country:US
Practice Address - Phone:401-861-2140
Practice Address - Fax:401-861-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental