Provider Demographics
NPI:1053014670
Name:DRAKOPOULOS, ANNA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIE
Last Name:DRAKOPOULOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 N 129TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-1283
Mailing Address - Country:US
Mailing Address - Phone:402-980-2337
Mailing Address - Fax:
Practice Address - Street 1:1 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2432
Practice Address - Country:US
Practice Address - Phone:773-456-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190343201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice