Provider Demographics
NPI:1487863338
Name:WIND, ROBERT JOSHUA (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSHUA
Last Name:WIND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4164
Mailing Address - Country:US
Mailing Address - Phone:845-357-6875
Mailing Address - Fax:845-357-6994
Practice Address - Street 1:2 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4164
Practice Address - Country:US
Practice Address - Phone:845-357-6875
Practice Address - Fax:845-357-6994
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044634122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist