NPIMap

Organization Active NPI

Gentle Dental Care of Rochester PC

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1134335466
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GENTLE DENTAL CARE OF ROCHESTER PC
Practice address
295 Monroe Ave
Rochester, NY 14607-3660
Phone
(585) 467-4513
Fax
(585) 467-4665
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Authorized official

Name
Manuel Alejandro Botana, DDSNPI 1053481143
Title
Owner
Phone
(585) 467-4513

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

295 Monroe Ave
Rochester, NY 14607-3660

Mailing address

295 Monroe Ave
Rochester, NY 14607-3660
Phone (585) 467-4513

Other identifiers 6

IdentifierTypeStateIssuer
02289081MedicaidNY
02646986MedicaidNY
02667485MedicaidNY
01431401MedicaidNY
02808359MedicaidNY
02901348MedicaidNY

National Provider Directory

National Provider Directory

Locations

295 Monroe Ave
Rochester, NY 14607
Phone (585) 467-4513

Practitioners & affiliated clinicians

Practitioners 5

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": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374796800000",
    "number": "1134335466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146073660",
            "telephone_number": "585-467-4513",
            "fax_number": "585-467-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146073660",
            "telephone_number": "585-467-4513",
            "fax_number": "585-467-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTLE DENTAL CARE OF ROCHESTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2013-07-26",
        "status": "A",
        "authorized_official_last_name": "BOTANA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "ALEJANDRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-467-4513",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02289081",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02646986",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02667485",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01431401",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02808359",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02901348",
            "state": "NY"
        }
    ],
    "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, 2013; 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.