Vanesza Robles Salas, M.P.H., D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

056820 Issued in NY

Practice address

3 Medical Dr Ste D
Port Jefferson Station, NY 11776-1597

Phone

(631) 928-7500

NPI assigned

Mar 28, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Victoria E. Shack, DDS, PC

  • Dentist
  • Port Jefferson Station, NY
  • NPI 1366896466
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1780950279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 MOUNT SINAI AVE",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117662312",
            "telephone_number": "631-347-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL DR STE D",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761597",
            "telephone_number": "631-928-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Technology Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "East Setauket",
            "state": "NY",
            "postal_code": "117333327",
            "country_code": "US",
            "telephone_number": "631-751-6700",
            "fax_number": "631-656-0143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Bergen St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032495",
            "country_code": "US",
            "telephone_number": "787-240-8057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 E Main St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "11787",
            "country_code": "US",
            "telephone_number": "631-656-0144",
            "fax_number": "631-656-0143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBLES SALAS",
        "first_name": "VANESZA",
        "name_prefix": "Dr.",
        "credential": "M.P.H., D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "056820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ria Rivera
• Alaina Rizzo
• Robert H. Kramer, D.O., P.C.
• Sabrina Roberts, PHARMD
• Jessica Young Robertson
• Jeannette Lillian Rodgers, RN
• Philip Gerard Rodgers, RN
• Sandra Roditti
• Ramon Omar Rodriguez Hernandez
• Oscar Andres Rodriguez-Ayala, MD

• Periodontics in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.