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General NPI Number Information
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NPI Number | 1184181083
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Entity Type | Individual
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Provider Name | DMITRIY KLASS DDS
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Gender | Male
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 163 MAIN ST STE A
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City | HACKENSACK
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State | NJ
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Zip | 07601-7124
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Country | US
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Telephone | 201-488-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 100 HARBOR BLVD 906N
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City | WEEHAWKEN
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State | NJ
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Zip | 07086
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Country | US
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Telephone | 646-808-4568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 22DI03005400
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License Number State | NJ
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