Provider Demographics
NPI:1285684209
Name:AHN, SARAH SUN-YOUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SUN-YOUNG
Last Name:AHN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SUN-YOUNG
Other - Middle Name:
Other - Last Name:AHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:50 W 127TH ST
Mailing Address - Street 2:UNIT 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3934
Mailing Address - Country:US
Mailing Address - Phone:732-763-3771
Mailing Address - Fax:
Practice Address - Street 1:2016 BRONXDALE AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-3388
Practice Address - Country:US
Practice Address - Phone:718-792-7972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030904L1223P0221X
NJ22DI0229080001223P0221X
NY0537721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03338456Medicaid