Individual provider Active NPI

Iswara Parvathaneni, DDS

  • Dentist
  • Rochester, NY
National Provider Identifier
1013070994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47228 Issued in NY
Practice address
2255 Ridge Rd E
Rochester, NY 14622-2611
Phone
(585) 544-8220
Fax
(585) 544-8577
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 47228 NY Primary

Addresses

Primary practice location

2255 Ridge Rd E
Rochester, NY 14622-2611

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160411001131 NY Order and Referring Only - DentistPractitioner - Dentist 7810295763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47228NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Dental of Rochester, PLLC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013070994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000",
            "fax_number": "315-545-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 RIDGE RD E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146222611",
            "telephone_number": "585-544-8220",
            "fax_number": "585-544-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARVATHANENI",
        "first_name": "ISWARA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "47228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.