Provider Demographics
NPI:1417268624
Name:KOZLOVSKY, YANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:YANA
Middle Name:
Last Name:KOZLOVSKY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SARATOGA CT
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2646
Mailing Address - Country:US
Mailing Address - Phone:201-574-5586
Mailing Address - Fax:
Practice Address - Street 1:2 SARATOGA CT
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-2646
Practice Address - Country:US
Practice Address - Phone:201-574-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024470001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry