Modern Periodontics, PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

042046 Issued in NY

Legal business name

MODERN PERIODONTICS, PC

Practice address

1680 Monroe Ave
Suite a
Rochester, NY 14618-1417

Phone

(585) 242-8980

Fax

(585) 256-0578

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Allan John Romeo, DMDNPI 1265518013

Title

President

Phone

(585) 242-8980

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Allan John Romeo, DMD

  • Periodontics
  • Rochester, NY
  • NPI 1265518013
  NPD (past) Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801984901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 MONROE AVE",
            "address_2": "SUITE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146181417",
            "telephone_number": "585-242-8980",
            "fax_number": "585-256-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 MONROE AVE",
            "address_2": "SUITE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146181417",
            "telephone_number": "585-242-8980",
            "fax_number": "585-256-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN PERIODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROMEO",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-242-8980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "042046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Simone Mobley-Dixon, L.P.N.
• Nikki Vanilla Mobley
• Lorraine Ann Mocniak, COTA
• Model of Resilience Psychotherapy
• Model of Resilience Psychotherapy LCSW PLLC
• Persephone Yolanda Modeste, LMHC
• James George Modico
• Colette Johanna Modrak, AGPCNP
• Geneva Modrak, CRNA
• Joseph Modrak, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.