Provider Demographics
NPI:1790891042
Name:YAMPOLSKY, SVETLANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:YAMPOLSKY
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 1:501 5TH AVE
Mailing Address - Street 2:SUITE 2102
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-286-1414
Mailing Address - Fax:212-286-4444
Practice Address - Street 1:501 5TH AVE
Practice Address - Street 2:SUITE 2102
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-286-1414
Practice Address - Fax:212-286-4444
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0498021122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist