Provider Demographics
NPI:1730128562
Name:STRUSS, EDWIN F (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:F
Last Name:STRUSS
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 1:965 WOODGLEN CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-5099
Mailing Address - Country:US
Mailing Address - Phone:859-273-7856
Mailing Address - Fax:
Practice Address - Street 1:153 BURT RD
Practice Address - Street 2:SUITE 3
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2410
Practice Address - Country:US
Practice Address - Phone:859-278-7434
Practice Address - Fax:859-278-7435
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4471122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist