Provider Demographics
NPI:1427461961
Name:MASASCHI-SANCHEZ, MILUSKA (DDS)
Entity type:Individual
Prefix:DR
First Name:MILUSKA
Middle Name:
Last Name:MASASCHI-SANCHEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4595 VAN BUREN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1080
Mailing Address - Country:US
Mailing Address - Phone:240-424-5361
Mailing Address - Fax:
Practice Address - Street 1:4595 VAN BUREN ST STE 230
Practice Address - Street 2:
Practice Address - City:RIVERDALE PARK
Practice Address - State:MD
Practice Address - Zip Code:20737-1080
Practice Address - Country:US
Practice Address - Phone:240-424-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15512122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD800150940Medicaid