Healthcare Provider Details

I. General information

NPI: 1043356975
Provider Name (Legal Business Name): ANNA ROSSIS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 LANCASTER AVE
MALVERN PA
19355-2122
US

IV. Provider business mailing address

183 LANCASTER AVE
MALVERN PA
19355-2122
US

V. Phone/Fax

Practice location:
  • Phone: 978-830-4610
  • Fax:
Mailing address:
  • Phone: 610-540-7008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS036570
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number21716
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: