Provider Demographics
NPI:1912039447
Name:SKY, ZOYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZOYA
Middle Name:
Last Name:SKY
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 1:14802 BRIARCLIFF PL
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6639
Mailing Address - Country:US
Mailing Address - Phone:718-501-7173
Mailing Address - Fax:
Practice Address - Street 1:2500 ALTON PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5024
Practice Address - Country:US
Practice Address - Phone:949-861-2500
Practice Address - Fax:949-861-2501
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA622551223G0001X
NY052725-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice