Provider Demographics
NPI:1730373291
Name:SVERDLOVA, YANA (DMD)
Entity type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:SVERDLOVA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-2591
Mailing Address - Country:US
Mailing Address - Phone:201-342-2543
Mailing Address - Fax:
Practice Address - Street 1:1060 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-2591
Practice Address - Country:US
Practice Address - Phone:201-342-2543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023331001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice