Provider Demographics
NPI:1619022449
Name:CAPLASH, JOLLY M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOLLY
Middle Name:M
Last Name:CAPLASH
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 1:10 HAGEN DR STE 230
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2659
Mailing Address - Country:US
Mailing Address - Phone:585-442-1492
Mailing Address - Fax:
Practice Address - Street 1:10 HAGEN DR STE 230
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2659
Practice Address - Country:US
Practice Address - Phone:585-442-1492
Practice Address - Fax:585-586-4460
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0480251223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY172143ATOtherPREFERRED CARE
NY208490972OtherDELTA DENTAL
NYP010048025OtherBLUE CHOICE
NY208490972OtherHEALTHPLEX
NY70692OtherEXCELLUS (MEDICAL)
NY70692JCOtherEXCELLUS DENTAL
NYV05114Medicare UPIN
NYP010048025OtherBLUE CHOICE