Provider Demographics
NPI:1447829288
Name:BSIRINI, OLIVER ZICO (DMD)
Entity type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:ZICO
Last Name:BSIRINI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 BASELINE LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-2078
Mailing Address - Country:US
Mailing Address - Phone:727-815-5509
Mailing Address - Fax:
Practice Address - Street 1:2450 53RD ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32967-7710
Practice Address - Country:US
Practice Address - Phone:772-217-5199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25958122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist