Fantuzzo Oral, Maxillofacial, and Dental Implant Surgery, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

048604 Issued in NY

Legal business name

FANTUZZO ORAL, MAXILLOFACIAL, AND DENTAL IMPLANT SURGERY, PLLC

Practice address

77 Mahogany Run
Pittsford, NY 14534-9424

Phone

(585) 203-1524

NPI assigned

Feb 26, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Joseph J Fantuzzo, DDS AND MDNPI 1073620373

Title

Owner/Provider

Phone

(585) 203-1524

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

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

• Joseph J Fantuzzo, D.D.S, M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester, NY
  • NPI 1073620373
  Medicare reassignment Care Compare group NPD Authorized official
• Molly Antoinette Christie, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester, NY
  • NPI 1578183810
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1275925380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 CLINTON AVE. SOUTH SUITE 320",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MAHOGANY RUN",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145349424",
            "telephone_number": "585-203-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANTUZZO ORAL, MAXILLOFACIAL, AND DENTAL IMPLANT SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "FANTUZZO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "585-203-1524",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS AND MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "048604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Mackey Erturk, RN
• Mary Juanita Erway, NP
• Stephen Evangelisti, MD
• Evolve Physical Therapy of Rochester PLLC
• Patricia Fama, P.T.
• Rachel Leah Farkas, M.D.
• Evan Schweigert Farley, LCSW
• Yoko Farmer, LCSW
• Vincent Joseph Fasanello, MD
• Andrea Faulkner, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Pittsford, NY
• Providers in Pittsford, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.