Individual provider Active NPI

David Michael Dow II, DDS, MS

  • Endodontics
  • Fairport, NY
National Provider Identifier
1366601957
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
060337 Issued in NY
Practice address
6800 Pittsford Palmyra Rd Ste 110
Fairport, NY 14450-3514
Phone
(585) 223-5330
NPI assigned
Jun 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 060337 NY Primary

Addresses

Primary practice location

6800 Pittsford Palmyra Rd Ste 110
Fairport, NY 14450-3514

Mailing address

6800 Pittsford Palmyra Rd Ste 110
Fairport, NY 14450-3514
Phone (585) 223-5330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190807003596 NY Order and Referring Only - DentistPractitioner - Dentist 2668709056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
060337NYMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester Endodontics Endodontics PastSince Aug 11, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1366601957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PITTSFORD PALMYRA RD STE 110",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503514",
            "telephone_number": "585-223-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 PITTSFORD PALMYRA RD STE 110",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503514",
            "telephone_number": "585-223-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOW",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "060337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

Verify at the official NPI Registry.