Provider Demographics
NPI:1922282128
Name:OSKOTSKAYA, YELENA (DDS)
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:OSKOTSKAYA
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 1:7101 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1662
Mailing Address - Country:US
Mailing Address - Phone:718-836-1200
Mailing Address - Fax:718-836-1040
Practice Address - Street 1:7101 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1662
Practice Address - Country:US
Practice Address - Phone:718-836-1200
Practice Address - Fax:718-836-1040
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0449911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01470800Medicaid