Provider Demographics
NPI:1164565636
Name:SUNSET DENTAL, PC
Entity Type:Organization
Organization Name:SUNSET DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAPPORT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-439-4646
Mailing Address - Street 1:6018 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4012
Mailing Address - Country:US
Mailing Address - Phone:718-439-4646
Mailing Address - Fax:718-439-4644
Practice Address - Street 1:6018 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4012
Practice Address - Country:US
Practice Address - Phone:718-439-4646
Practice Address - Fax:718-439-4644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045521261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental