Provider Demographics
NPI:1538735584
Name:DALAYA, ROOSHIKA (DDS)
Entity type:Individual
Prefix:DR
First Name:ROOSHIKA
Middle Name:
Last Name:DALAYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 S MOUNTAIN RD # 1
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5731
Mailing Address - Country:US
Mailing Address - Phone:516-984-5886
Mailing Address - Fax:
Practice Address - Street 1:21 BAY STATE RD
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-1521
Practice Address - Country:US
Practice Address - Phone:413-625-3013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN100001421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice