NPIMap

Organization Active NPI

White Spruce Dental,PLLC

  • Dentist
  • Rochester, NY
National Provider Identifier
1063602019
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
038751 Issued in NY
Legal business name
WHITE SPRUCE DENTAL,PLLC
Practice address
935 E Henrietta Rd
Rochester, NY 14623-1409
Phone
(585) 424-5120
Fax
(585) 424-1743
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Authorized official

Name
Dr. Kenneth D. Nozik, DDSNPI 1134259740
Title
Partner
Phone
(585) 424-5120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 038751 NY Primary

Addresses

Primary practice location

935 E Henrietta Rd
Rochester, NY 14623-1409

Mailing address

935 E Henrietta Rd
Rochester, NY 14623-1409
Phone (585) 424-5120

National Provider Directory

National Provider Directory

Locations

935 E Henrietta Rd
Rochester, NY 14623
Phone (585) 424-5120

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1063602019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231409",
            "telephone_number": "585-424-5120",
            "fax_number": "585-424-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231409",
            "telephone_number": "585-424-5120",
            "fax_number": "585-424-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE SPRUCE DENTAL,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "NOZIK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "585-424-5120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "038751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.