Provider Demographics
NPI:1134510480
Name:CHICOSKY, SARAH MARGARITA (DDS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARGARITA
Last Name:CHICOSKY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARGARITA
Other - Last Name:ORDONEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2 OTEGO PL
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-3008
Mailing Address - Country:US
Mailing Address - Phone:631-897-6367
Mailing Address - Fax:
Practice Address - Street 1:562 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-7314
Practice Address - Country:US
Practice Address - Phone:631-760-7606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0593811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program