Pedersen Dentistry, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PEDERSEN DENTISTRY, PLLC

Practice address

400 Westfall Rd
Rochester, NY 14620-4606

Phone

(585) 473-3880

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Todd Richard Pedersen, DDSNPI 1215316583

Title

Member

Phone

(585) 469-5433

Specialties & licenses 1

Addresses

Other names 1

• Rochester Modern Dentistry Other name

Locations

Practitioners 2

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

• Todd Richard Pedersen, D.D.S.

  • Student in an Organized Health Care Education/Training Program
  • Rochester, NY
  • NPI 1215316583
  NPD Authorized official
• Stephen Robert Burgart, DDS

  • General Practice Dentistry
  • Rochester, NY
  • NPI 1124023858
  NPD (past)

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1679231591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ALAMEDA DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WESTFALL RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204606",
            "telephone_number": "585-473-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDERSEN DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "585-469-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rochester Modern Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Pecora
• Nicole Danielle Pecora, MD/PHD
• Janet Louise Pecorella
• Madelyn Pecyne, PA
• Ped Physical Disabilities
• Todd Richard Pedersen, D.D.S.
• Andrew Steven Pederzolli, M.D.
• Pediatric Allergy of Pulmonary
• Pediatric Cardiac Surgery of the University of Rochester
• Pediatric Cardiology

• Dentist in Rochester, NY
• Providers in Rochester, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.