1396816237 NPI number — SANSONE FAMILY DENTAL PRACTICE, L.L.P.

Table of content: MEGAN CARROLL GETHING M.D. (NPI 1518351519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396816237 NPI number — SANSONE FAMILY DENTAL PRACTICE, L.L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANSONE FAMILY DENTAL PRACTICE, L.L.P.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396816237
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4343 DEWEY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14616-1206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-663-1390
Provider Business Mailing Address Fax Number:
585-865-9126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4343 DEWEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14616-1206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-663-1390
Provider Business Practice Location Address Fax Number:
585-865-9126
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SANSONE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
585-663-1390

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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