NPIMap

Organization Active NPI

Smiles on the Canal Dentistry

  • General Practice Dentistry
  • Fairport, NY
National Provider Identifier
1548822786
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMILES ON THE CANAL DENTISTRY
Practice address
124 Fairport Village LNDG
Fairport, NY 14450-1804
Phone
(585) 223-5480
NPI assigned
Jul 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Authorized official

Name
Damian Graybelle
Title
Director of Operations
Phone
(585) 223-5480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X

Addresses

Primary practice location

124 Fairport Village LNDG
Fairport, NY 14450-1804

Mailing address

124 Fairport Village LNDG
Fairport, NY 14450-1804
Phone (585) 223-5480

National Provider Directory

National Provider Directory

Locations

124 Fairport Village Lndg
Fairport, NY 14450
Phone (585) 223-5480

Practitioners & affiliated clinicians

Practitioners 3

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": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1548822786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 FAIRPORT VILLAGE LNDG",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501804",
            "telephone_number": "585-223-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 FAIRPORT VILLAGE LNDG",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501804",
            "telephone_number": "585-223-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES ON THE CANAL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "GRAYBELLE",
        "authorized_official_first_name": "DAMIAN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "585-223-5480"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.