Individual
DR. SOPHIA DYAKIV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
138 ELMWOOD AVE, HO HO KUS, NJ 07423-1502
(646) 643-1951
Mailing address
138 ELMWOOD AVE, HO HO KUS, NJ 07423-1502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
049548
NY
1223G0001X
General Practice Dentistry
Primary
22DI02218300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02259438
—
NY
Enumeration date
05/20/2008
Last updated
10/22/2008
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