Provider Demographics
NPI:1912044017
Name:YARMOLINSKAYA, SVETLANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:YARMOLINSKAYA
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 1:26-07 BROADWAY
Mailing Address - Street 2:SUITE 23
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3832
Mailing Address - Country:US
Mailing Address - Phone:201-791-2170
Mailing Address - Fax:201-791-2669
Practice Address - Street 1:26-07 BROADWAY
Practice Address - Street 2:SUITE 23
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3832
Practice Address - Country:US
Practice Address - Phone:201-791-2170
Practice Address - Fax:201-791-2669
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020159001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice