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SAND LANE DENTAL PC
NPI 1649318601
Dentist - General Practice in Staten Island, NY

Active since February 02, 2007
128 SAND LN, STATEN ISLAND, NY 10305(718) 273-5006(718) 273-2778 Get Directions Write a Review

NPPES record last updated: December 22, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sand Lane Dental Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAND LANE DENTAL PC (NPI 1649318601) is a healthcare organization registered as a general practice in Staten Island, New York and active in the NPI registry since February 2007. The organization lists Andzhela P Tkachuk, Director, as its authorized official.

NPPES Registry Identity

NPI1649318601
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSAND LANE DENTAL PC
Location Address128 SAND LNStaten Island, NY 10305-4543
Mailing Address67 Clawson StStaten Island, NY 10306-3222 · (718) 273-5006 · Fax (718) 273-2778
Phone(718) 273-5006
Fax(718) 273-2778
Organization SubpartNo
Authorized OfficialAndzhela P TkachukDirector · (718) 273-5006
Enumeration DateFebruary 2, 2007
Last NPPES UpdateDecember 22, 2010
✔ NPI 1649318601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NY · 050679
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
128 SAND LN, Staten Island, NY 10305
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Other Identifiers 5

Medicare PINA00027936NY
Medicaid02410680NY
Medicaid02408771NY
Medicare PINA400027931NY
Medicare PINA100026997NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANZHELA TKACHUK DDS
Dentist (General Practice)
128 SAND LN, 1ST FLOOR
STATEN ISLAND, NY 10305
Richmond County (718) 273-5006
LYUBOV KRUT DDS
Dentist (General Practice)
128 SAND LN
STATEN ISLAND, NY 10305
Richmond County (718) 273-5006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sand Lane Dental PC's NPI number?

The NPI number for Sand Lane Dental PC is 1649318601. It was assigned to this organization in the NPPES registry on February 2, 2007.

Where is Sand Lane Dental PC located?

Sand Lane Dental PC is located at 128 Sand Ln, Staten Island, NY 10305. The listed phone number is (718) 273-5006.

What is Sand Lane Dental PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Sand Lane Dental PC was last updated on December 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.