Provider Demographics
NPI:1558559211
Name:SAPOZHNIKOFF, LENA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:LENA
Middle Name:A
Last Name:SAPOZHNIKOFF
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 1:66 W 94TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7137
Mailing Address - Country:US
Mailing Address - Phone:212-662-7400
Mailing Address - Fax:222-662-7402
Practice Address - Street 1:66 W 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7137
Practice Address - Country:US
Practice Address - Phone:212-662-7400
Practice Address - Fax:222-662-7402
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0542001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03238213Medicaid