Stelianos Alexandros Bredologos, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401008291 Issued in VA

Practice address

1917 Laskin Rd Ste 106
Virginia Beach, VA 23454-4283

Phone

(757) 425-1828

Fax

(757) 425-1834

NPI assigned

Feb 23, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bredologos Family Dentistry

  • General Practice Dentistry
  • Virginia Beach, VA
  • NPI 1649305467
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487789988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 LASKIN RD STE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544283",
            "telephone_number": "757-425-1828",
            "fax_number": "757-425-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 LASKIN RD STE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544283",
            "telephone_number": "757-425-1828",
            "fax_number": "757-425-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDOLOGOS",
        "first_name": "STELIANOS",
        "middle_name": "ALEXANDROS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breakthrough Collective LLC
• Breakthrough Glow, LLC
• Breath of Life Wellness Spa, LLC
• Regan M Brecke, PA
• Bredologos Family Dentistry
• Hal Westley Breedlove, OD
• Shamyka Antoinette Breese
• Randy Scott Breidel, SUB IDC
• Byron David Breininger, DDS
• Sandia Y Brekke, MD

• General Practice Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.