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General NPI Number Information
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NPI Number | 1225396682
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Entity Type | Organization
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Legal Business Name | SASHA CEKADA DDS P C
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 193 BROADWAY SUITE 2
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City | AMITYVILLE
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State | NY
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Zip | 11701-2761
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Country | US
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Telephone | 631-598-2940
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Fax | 631-598-8287
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Provider Business Mailing Address
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Address Line | 193 BROADWAY SUITE 2
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City | AMITYVILLE
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State | NY
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Zip | 11701-2761
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Country | US
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Telephone | 631-598-2940
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Fax | 631-598-8287
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Authorized Official
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Title or Position | OWNER
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Name | DR. SASHA DANIEL CEKADA
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Credential | DDS
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Telephone | 631-598-2940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 049684
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License Number State | NY
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