Juan Carlos Kassab, D.M.D
Individual provider Active NPI General Practice Dentistry · Canastota, NY
NPI 1992729271 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992729271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 044335 (NY)
- Practice address
- 118 S Main St
Canastota, NY 13032-1234 - Phone
- (315) 697-9287
- Fax
- (315) 697-4038
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044335 | NY | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 044335 | 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
Other providers in Canastota, NY
- Greater Lenox Ambulance Service Inc
- Patrick Earl Howlett
- Kayla Jorden
- Juan C Kassab DMD and Dorothy Kassab DDS PLLC
- Dorothy Kassab
- Diane C Keba
- Jocelyne A King
- Knox Chiropractic Care PC
- Nanci Lynne Knox
- Melissa Elaine Kotary
All providers in Canastota, NY · General Practice Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.