Individual provider Active NPI

Jason Gunther

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1518667138
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
064151 Issued in NY
Practice address
1455 E Ridge Rd
Rochester, NY 14621-2006
Phone
(585) 974-5045
NPI assigned
Mar 3, 2023
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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 064151 NY Primary

Addresses

Primary practice location

1455 E Ridge Rd
Rochester, NY 14621-2006

Mailing address

10 Brook St
Canandaigua, NY 14424-1328
Phone (585) 394-8071

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
064151NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lux Dental General Practice CurrentSince Aug 18, 2024 Accepting new patients

Locations

10 Brook St
Canandaigua, NY 14424
Phone (585) 394-8071

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1518667138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BROOK ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241328",
            "telephone_number": "585-394-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212006",
            "telephone_number": "585-974-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTHER",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-03",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "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": "064151",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 16, 2024; 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.