Provider Demographics
NPI:1669402210
Name:RAY, ROCKLAND ALLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROCKLAND
Middle Name:ALLAN
Last Name:RAY
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 1:26777 LORAIN ROAD
Mailing Address - Street 2:SUITE 514
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070
Mailing Address - Country:US
Mailing Address - Phone:440-734-7373
Mailing Address - Fax:440-734-4984
Practice Address - Street 1:26777 LORAIN ROAD
Practice Address - Street 2:SUITE 514
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070
Practice Address - Country:US
Practice Address - Phone:440-734-7373
Practice Address - Fax:440-734-4984
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH219411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
112774OtherCIGNA HMO
000000344923OtherANTHEM
341373074026OtherCARESOURCE
9177625OtherDORAL
603924OtherCOMPBENEFITS
OH2505695Medicaid
476811OtherUNITED CONCORDIA