IndividualActive
Anastassios Koussis, DDS
NPI 1629199484 · Dentist · Media, PA
Provider details
- NPI number
- 1629199484
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- DS014874L (PA)
Mailing address
1245 N Providence Rd
Media, PA 19063-1210
Registry dates
- Enumerated
- 2007-04-02
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.