Individual provider Active NPI

John A Bacchetta, D.D.S

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1811069354
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0426751 Issued in NY
Practice address
1300 Jefferson Rd Ste 300
Rochester, NY 14623-3195
Phone
(585) 625-1250
Fax
(585) 625-1258
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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 0426751 NY Primary

Addresses

Primary practice location

1300 Jefferson Rd Ste 300
Rochester, NY 14623-3195

Mailing address

1300 Jefferson Rd Ste 300
Rochester, NY 14623-3195
Phone (585) 625-1250

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
I20160225002067 NY Order and Referring Only - DentistPractitioner - Dentist 0042515231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0426751NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1811069354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 JEFFERSON RD STE 300",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233195",
            "telephone_number": "585-625-1250",
            "fax_number": "585-625-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JEFFERSON RD STE 300",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233195",
            "telephone_number": "585-625-1250",
            "fax_number": "585-625-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHETTA",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0426751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.