Brockport Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BROCKPORT DENTAL PLLC

Practice address

1000 Transit Way # 200
Brockport, NY 14420-3008

Phone

(585) 957-0981

NPI assigned

Jun 23, 2022

Last updated

Jun 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alexis Ghanem Ayoubi, DDS

Title

President

Phone

(585) 503-0713

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Irina Elena Gulerez, DMD

  • Dentist
  • Brockport, NY
  • NPI 1922660513
  NPD

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1114658614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WATERBURY LN",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146251361",
            "telephone_number": "585-503-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TRANSIT WAY # 200",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144203008",
            "telephone_number": "585-957-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKPORT DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "GHANEM AYOUBI",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-503-0713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geena Brady, PT
• Brian Reid Briggs, PT
• Jessica Marie Brightly, RDN
• Loretta Anne Brigman, PA
• Brockport Central School District
• Brockport Internal Medicine, PC
• Brockport Marriage & Family Therapy, P.C.
• Brockport Medical Care PLLC (Brockport ASAP Medical Care)
• Brockport Optometry, PC
• Brockport Optometry, PC

• General Practice Dentistry in Brockport, NY
• Providers in Brockport, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.