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Export Provider Record NPI 1396961546
Katherine MantzikosDMD
Active
NPI Number1396961546
NPI TypeNPI-1 Individual
SpecialtyDentist, Periodontics
Provider Details
NPI1396961546
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2007-04-17
Last Updated2007-07-08
Mailing Address5031 194th St
Fresh Meadows, NY 11365-1238
United States
Phone: (917) 833-0295
📍 View Map
Primary Practice Address5031 194th St
Fresh Meadows, NY 11365-1238
United States
Phone: (917) 833-0295
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes1223P0300X – Dentist, PeriodonticsNY050197
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About NPI 1396961546

Katherine Mantzikos DMD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1396961546. The primary specialty listed is Dentist, Periodontics. The provider is located in Fresh Meadows, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-04-17. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1396961546?

NPI 1396961546 belongs to Katherine Mantzikos DMD, a Dentist, Periodontics in Fresh Meadows, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1396961546 active?

The current status of NPI 1396961546 in the NPPES registry is Active. The record was last updated on 2007-07-08.

What specialty is NPI 1396961546?

NPI 1396961546 is classified under the taxonomy Dentist, Periodontics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1396961546?

You can verify NPI 1396961546 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1396961546?

The primary practice address on file for NPI 1396961546 is 5031 194th St, Fresh Meadows, NY 11365-1238. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1396961546 issued?

NPI 1396961546 was first issued (enumerated) on 2007-04-17. The NPPES record was last updated on 2007-07-08.

Practice Location Map

Katherine Mantzikos is located at 5031 194th St, Fresh Meadows, NY. Use the map below to find directions or verify the practice location.

📍 5031 194th St, Fresh Meadows, NY 11365-1238  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Katherine Mantzikos. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1396961546. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Dentist, Periodontics050197NY
Data Verified from CMS NPPES Last synced: 2026-08-24 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162