Azita Anissi, D.D.S.
Individual provider Active NPI Dentist · Pittsford, NY
NPI 1851326136 · NPPES record last updated Oct 9, 2009
Key facts
- NPI
- 1851326136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 043423-1 (NY)
- Practice address
- 121 Sully'S Trail
Suite 1
Pittsford, NY 14534 - Phone
- (585) 267-7745
- Fax
- (585) 267-7748
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 30, 2024 through Dec 30, 2026
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043423-1 | NY | MD | Dentist |
| 043423 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Azita Anissi DDS | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 043423-1 | NY | Yes |
Addresses
Primary practice location
121 Sully'S Trail
Suite 1
Pittsford, NY 14534
Mailing address
121 Sully'S Trail
Suite 1
Pittsford, NY 14534
Phone (585) 267-7745
Other providers in Pittsford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.