Healthcare Provider Details

I. General information

NPI: 1730633678
Provider Name (Legal Business Name): GREGORY KASS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 HEMION RD
SUFFERN NY
10901-4919
US

IV. Provider business mailing address

7 HEMION RD
SUFFERN NY
10901-4919
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-3244
  • Fax:
Mailing address:
  • Phone: 845-896-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number058752
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number22DI02649500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: