Provider Demographics
NPI:1962664631
Name:SONRIA DENTAL CARE P.C.
Entity Type:Organization
Organization Name:SONRIA DENTAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-651-3311
Mailing Address - Street 1:8111 45TH AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3516
Mailing Address - Country:US
Mailing Address - Phone:718-651-3311
Mailing Address - Fax:718-651-3312
Practice Address - Street 1:8820 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7800
Practice Address - Country:US
Practice Address - Phone:718-651-3311
Practice Address - Fax:718-651-3312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050729-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02420139Medicaid