Organization Active NPI

Finger Lakes Dental Care, PC

  • General Practice Dentistry
  • Canandaigua, NY
National Provider Identifier
1104090513
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FINGER LAKES DENTAL CARE, PC
Practice address
329 South Main Street
Canandaigua, NY 14424
Phone
(585) 394-1930
Fax
(585) 394-1938
NPI assigned
Apr 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Authorized official

Name
Jennifer A Morello
Title
Director of Finance
Phone
(585) 919-6624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

329 South Main Street
Canandaigua, NY 14424

Mailing address

329 S Main St
Canandaigua, NY 14424-2118
Phone (585) 394-1930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170914001106 NY DME Supplier - Oral Surgery - Dentist 3870883812 Practice locations: Canandaigua, NY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765497600000",
    "number": "1104090513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 S MAIN ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144242118",
            "telephone_number": "585-394-1930",
            "fax_number": "585-394-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 SOUTH MAIN STREET",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "14424",
            "telephone_number": "585-394-1930",
            "fax_number": "585-394-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FINGER LAKES DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A",
        "authorized_official_last_name": "MORELLO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "585-919-6624"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.