Matytsin, Vlada
Matytsin, Vlada is an sole proprietor health care provider with primary practice located at 4840 Sweetwater Blvd Ste A , Sugar Land TX 77479. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Matytsin, Vlada can be contacted via phone (832) 939-9999.Contact Information
Primary practice address
4840 Sweetwater Blvd Ste A
Sugar Land TX 77479
Phone: (832) 939-9999
Fax: (832) 939-9997
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 30466 | Texas |
| Dental Providers / General Practice | 1223G0001X | 051337 | New York |
Profile Details
| NPI number | 1003964339 |
|---|---|
| LBN Legal business name | Matytsin, Vlada |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Aug 13th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003964339 | NPPES |
| Texas | MEDICAID | 3403552-05 | |
| Texas | MEDICAID | 3403552-04 | |
| Texas | MEDICAID | 3403552-06 | |
| Texas | MEDICAID | 02608157 |
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