Provider Demographics
NPI:1043256555
Name:SOKOLOVSKIY, SVYATOSLAV (DDS)
Entity Type:Individual
Prefix:DR
First Name:SVYATOSLAV
Middle Name:
Last Name:SOKOLOVSKIY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 ASPENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1700
Mailing Address - Country:US
Mailing Address - Phone:716-639-1035
Mailing Address - Fax:
Practice Address - Street 1:6 BATAVIA CITY CTR
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2107
Practice Address - Country:US
Practice Address - Phone:585-343-4246
Practice Address - Fax:585-343-4718
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist