Provider Demographics
NPI:1417173535
Name:KAPLAN, SANDRA LISA (DDS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LISA
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2936 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4056
Mailing Address - Country:US
Mailing Address - Phone:718-987-6453
Mailing Address - Fax:718-980-4588
Practice Address - Street 1:2936 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4056
Practice Address - Country:US
Practice Address - Phone:718-987-6453
Practice Address - Fax:718-980-4588
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043422122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist