Provider Demographics
NPI:1255512299
Name:SANDS, PAMELA LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LYNN
Last Name:SANDS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:LYNN
Other - Last Name:SAMORODIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3471 LONG BEACH ROAD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572
Mailing Address - Country:US
Mailing Address - Phone:516-536-5800
Mailing Address - Fax:516-208-7447
Practice Address - Street 1:2882 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3114
Practice Address - Country:US
Practice Address - Phone:516-536-5800
Practice Address - Fax:516-536-3578
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0450211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry