Provider Demographics
NPI:1619955564
Name:CEKADA, SASHA DANIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:DANIEL
Last Name:CEKADA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25201 58TH AVE
Mailing Address - Street 2:#2
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2113
Mailing Address - Country:US
Mailing Address - Phone:718-767-3504
Mailing Address - Fax:718-969-3074
Practice Address - Street 1:193 BROADWAY
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2761
Practice Address - Country:US
Practice Address - Phone:631-598-2940
Practice Address - Fax:631-598-8287
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0496841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice