Provider Demographics
NPI:1760514186
Name:DASS, ROBERT AJAY (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:AJAY
Last Name:DASS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:AJAY
Other - Last Name:DASS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:125 WHITE SPRUCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1687
Mailing Address - Country:US
Mailing Address - Phone:585-424-5660
Mailing Address - Fax:585-424-1239
Practice Address - Street 1:125 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1687
Practice Address - Country:US
Practice Address - Phone:585-424-5660
Practice Address - Fax:585-424-1239
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0445191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice