Provider Demographics
NPI:1023030194
Name:STRAUSS, JERRY M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:M
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 PASSAIC AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-2017
Mailing Address - Country:US
Mailing Address - Phone:973-227-8998
Mailing Address - Fax:973-227-3881
Practice Address - Street 1:389 PASSAIC AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2017
Practice Address - Country:US
Practice Address - Phone:973-227-8998
Practice Address - Fax:973-227-3881
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 0210401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice