Individual provider Active NPI

Hannah Marchese, DDS

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1790216620
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
059889 Issued in NY
Practice address
2655 Ridgeway Ave Ste 360
Rochester, NY 14626-4296
Phone
(585) 290-1890
Fax
(585) 290-1898
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 059889 NY Primary

Addresses

Primary practice location

2655 Ridgeway Ave Ste 360
Rochester, NY 14626-4296

Mailing address

2655 Ridgeway Ave Ste 360
Rochester, NY 14626-4296
Phone (585) 290-1890

Other practice location 1

1445 East Ridge Road
Rochester, NY 14621-2006
Phone (585) 922-4103

Other practice location 2

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4103

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
I20180917001655 NY Order and Referring Only - DentistPractitioner - Dentist 2466703327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
059889NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1790216620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE STE 360",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-290-1890",
            "fax_number": "585-290-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE STE 360",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-290-1890",
            "fax_number": "585-290-1898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1445 East Ridge Road",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146212006",
            "country_code": "US",
            "telephone_number": "585-922-4103",
            "fax_number": "585-922-5952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213001",
            "country_code": "US",
            "telephone_number": "585-922-4103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCHESE",
        "first_name": "HANNAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.