Provider Demographics
NPI:1972194637
Name:KUYUNOV, OSNAT (DDS, MS)
Entity Type:Individual
Prefix:
First Name:OSNAT
Middle Name:
Last Name:KUYUNOV
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 68TH DR APT A12
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3475
Mailing Address - Country:US
Mailing Address - Phone:718-785-6672
Mailing Address - Fax:
Practice Address - Street 1:10421 68TH DR APT A12
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3475
Practice Address - Country:US
Practice Address - Phone:718-785-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0610781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics