Provider Demographics
NPI:1750307351
Name:SAKHNOVSKAYA, NINA (DDS)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:SAKHNOVSKAYA
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 1:2623 STATE HIGHWAY 30A
Mailing Address - Street 2:
Mailing Address - City:FONDA
Mailing Address - State:NY
Mailing Address - Zip Code:12068-5961
Mailing Address - Country:US
Mailing Address - Phone:518-853-1400
Mailing Address - Fax:518-853-1399
Practice Address - Street 1:2623 STATE HIGHWAY 30A
Practice Address - Street 2:
Practice Address - City:FONDA
Practice Address - State:NY
Practice Address - Zip Code:12068-5961
Practice Address - Country:US
Practice Address - Phone:518-853-1400
Practice Address - Fax:518-853-1399
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0485541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice