Dorothy Kassab, D.D.S.

Individual provider Active NPI General Practice Dentistry · Canastota, NY

NPI 1245253137 · NPPES record last updated Oct 18, 2021

Key facts

NPI
1245253137
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
049074 (NY)
Practice address
118 S Main St
Canastota, NY 13032-1234
Phone
(315) 697-9287
Fax
(315) 697-4038
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Opted out of Medicare
Yes, effective Jul 10, 2023 through Jul 10, 2027

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
049074NYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049074 NY Yes

Addresses

Primary practice location

118 S Main St
Canastota, NY 13032-1234

Mailing address

118 S Main St
Canastota, NY 13032-1234
Phone (315) 697-9287

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address info@smilesolutionsofcny.com Direct

Other providers in Canastota, NY

All providers in Canastota, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.