National Provider Identifier

Ross Spencer Phippen Jr., DMD

Ross Spencer Phippen Jr., DMD is listed in the NPPES registry with a primary specialty of Dentist in Penn Yan, NY and a listed phone number of (315) 536-2024.

NPI 1104154111Penn Yan, NYDentist

Profile Overview

NPI
1104154111
Provider Type
Individual
Primary Specialty
Dentist
Enumeration Date
December 02, 2009
Last Updated
March 07, 2023

Practice Location

  • 160 Main St
  • Penn Yan, NY 14527-1204

Phone: (315) 536-2024

Mailing Address

  • 14 Maiden Ln
  • PO Box 423
  • Penn Yan, NY 14527-1208

Specialties

  • Dentist (122300000X)
Full Record
NPI
1104154111
Entity Type
Individual
Last Name
Phippen
First Name
Ross
Middle Name
Spencer
Name Suffix
Jr.
Credential
DMD
Mailing Street Address
14 Maiden Ln
Mailing Address Line 2
PO Box 423
Mailing City
Penn Yan
Mailing State
NY
Mailing ZIP Code
14527-1208
Mailing Country
US
Mailing Phone
(315) 531-9102
Mailing Fax
(315) 531-9103
Practice Street Address
160 Main St
Practice City
Penn Yan
Practice State
NY
Practice ZIP Code
14527-1204
Practice Country
US
Practice Phone
(315) 536-2024
Practice Fax
(315) 536-4005
Enumeration Date
December 02, 2009
Last Updated
March 07, 2023
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Dentist (122300000X)
Other Identifiers
058689 (NY, License), 04559624 (NY)