Provider Demographics
NPI:1134218589
Name:NASSIF, ROBERT A JR (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:NASSIF
Suffix:JR
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 1:305 PINTO PL
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-2153
Mailing Address - Country:US
Mailing Address - Phone:724-772-8889
Mailing Address - Fax:724-772-8922
Practice Address - Street 1:2 PARKWAY CTR
Practice Address - Street 2:SUITE G-1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3510
Practice Address - Country:US
Practice Address - Phone:412-937-1900
Practice Address - Fax:412-937-9014
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADA028723A1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU64292Medicare UPIN
PA601747Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER