Healthcare Provider Details

I. General information

NPI: 1902535727
Provider Name (Legal Business Name): DR. RASHANIQUE DUPLESSIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 GRAND CONCOURSE FL 6
BRONX NY
10453-8202
US

IV. Provider business mailing address

1775 GRAND CONCOURSE FL 6
BRONX NY
10453-8202
US

V. Phone/Fax

Practice location:
  • Phone: 718-590-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number063495
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: