Provider Demographics
NPI:1588755706
Name:YAVRU-SAKUK, BEDROS (DDS)
Entity type:Individual
Prefix:DR
First Name:BEDROS
Middle Name:
Last Name:YAVRU-SAKUK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-29 QUEENS BOULEVARD
Mailing Address - Street 2:STE # 1G
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:718-896-5739
Mailing Address - Fax:718-896-5739
Practice Address - Street 1:92-29 QUEENS BOULEVARD
Practice Address - Street 2:STE # 1G
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-896-5739
Practice Address - Fax:718-896-5739
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist