Provider Demographics
NPI:1306018908
Name:YAPOR DENTAL PC
Entity Type:Organization
Organization Name:YAPOR DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIO
Authorized Official - Middle Name:Y
Authorized Official - Last Name:YAPOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-740-0262
Mailing Address - Street 1:3825 BROADWAY FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1510
Mailing Address - Country:US
Mailing Address - Phone:212-740-0262
Mailing Address - Fax:212-740-7584
Practice Address - Street 1:3825 BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1510
Practice Address - Country:US
Practice Address - Phone:212-740-0262
Practice Address - Fax:212-740-7584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043767-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15575OtherDORAL DENTAL IPA OF NEW Y