Provider Demographics
NPI:1568843928
Name:DUKE, JASON ROSS (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ROSS
Last Name:DUKE
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 1:6600 UNIVERSITY PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9040
Mailing Address - Country:US
Mailing Address - Phone:318-560-9790
Mailing Address - Fax:
Practice Address - Street 1:6600 UNIVERSITY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-9040
Practice Address - Country:US
Practice Address - Phone:941-269-3367
Practice Address - Fax:941-231-0635
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65651223G0001X
NC100571223G0001X
FLDN272301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice