Individual provider Active NPI

Andrea Rose Gerchman, DDS

  • General Practice Dentistry
  • Canandaigua, NY
National Provider Identifier
1164165205
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
063125 Issued in NY
Practice address
329 S Main St
Canandaigua, NY 14424-2118
Phone
(585) 394-1930
NPI assigned
Apr 17, 2022
Last updated
Jul 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 063125 NY Primary

Addresses

Primary practice location

329 S Main St
Canandaigua, NY 14424-2118

Mailing address

2001 Bernard Blvd
Endicott, NY 13760-1412
Phone (607) 341-6533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
063125NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1650153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1164165205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BERNARD BLVD",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137601412",
            "telephone_number": "607-341-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 S MAIN ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144242118",
            "telephone_number": "585-394-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERCHMAN",
        "first_name": "ANDREA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-17",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063125",
            "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 Jul 8, 2023; 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.