Provider Demographics
NPI:1710217088
Name:SITTNER, ELANA Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELANA
Middle Name:Y
Last Name:SITTNER
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 1:335 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5408
Mailing Address - Country:US
Mailing Address - Phone:718-327-1208
Mailing Address - Fax:
Practice Address - Street 1:3159 OCEANSIDE RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-4248
Practice Address - Country:US
Practice Address - Phone:516-764-3461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0513321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice