Individual provider Active NPI

Marc Alan Rossow, DDS

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1023030434
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046559 Issued in NY
Practice address
2971 Culver Rd
Rochester, NY 14622-2832
Phone
(585) 266-2300
Fax
(585) 266-2312
NPI assigned
Jul 24, 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
General Practice Dentistry 1223G0001X 046559 NY Primary

Addresses

Primary practice location

2971 Culver Rd
Rochester, NY 14622-2832

Mailing address

2971 Culver Rd
Rochester, NY 14622-2832
Phone (585) 266-2300

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
I20160121002236 NY Order and Referring Only - DentistPractitioner - Dentist 0143523340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023030434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 CULVER RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146222832",
            "telephone_number": "585-266-2300",
            "fax_number": "585-266-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 CULVER RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146222832",
            "telephone_number": "585-266-2300",
            "fax_number": "585-266-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSOW",
        "first_name": "MARC",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.