Provider Demographics
NPI:1699528158
Name:TOKAREV, GRIGORY
Entity type:Individual
Prefix:DR
First Name:GRIGORY
Middle Name:
Last Name:TOKAREV
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:GREG
Other - Middle Name:
Other - Last Name:TOKAREV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7511 SW 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2721
Mailing Address - Country:US
Mailing Address - Phone:305-873-4601
Mailing Address - Fax:
Practice Address - Street 1:7511 SW 108TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2721
Practice Address - Country:US
Practice Address - Phone:305-873-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0351401223G0001X
FLDN304621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice