Provider Demographics
NPI:1992716799
Name:SAPOZHNIKOV, MOISA (DDS)
Entity type:Individual
Prefix:DR
First Name:MOISA
Middle Name:
Last Name:SAPOZHNIKOV
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 1:4632 SPYGLASS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7127
Mailing Address - Country:US
Mailing Address - Phone:214-293-4552
Mailing Address - Fax:
Practice Address - Street 1:1125 W FM 544 STE 50
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4965
Practice Address - Country:US
Practice Address - Phone:972-734-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201481223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice