Provider Demographics
NPI:1750279253
Name:DAAS, RIDER GUSTAAF (DMD)
Entity type:Individual
Prefix:DR
First Name:RIDER
Middle Name:GUSTAAF
Last Name:DAAS
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 1:1821 EDWARDS WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1806
Mailing Address - Country:US
Mailing Address - Phone:732-216-7236
Mailing Address - Fax:
Practice Address - Street 1:121 DONOHOE RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6986
Practice Address - Country:US
Practice Address - Phone:724-836-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS045222122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist