Organization Active NPI

Harborside Dental Team at Canandaigua

  • Dental Clinic/Center
  • Canandaigua, NY
National Provider Identifier
1942001078
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
HARBORSIDE DENTAL TEAM AT CANANDAIGUA
Practice address
3170 West St Ste 250
Canandaigua, NY 14424-1786
Phone
(585) 394-3737
Fax
(585) 394-3891
NPI assigned
Mar 24, 2025
Last updated
Mar 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Jordan J Antetomaso, DMD
Title
Owner
Phone
(585) 394-3736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3170 West St Ste 250
Canandaigua, NY 14424-1786

Mailing address

3170 West St Ste 250
Canandaigua, NY 14424-1786
Phone (585) 208-9285

Other names 1

  • Harborside Dental Team at Canandaigua Former legal business name

National Provider Directory

National Provider Directory

Locations

3170 West St
Ste 250
Canandaigua, NY 14424
Phone (585) 394-3736

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1942001078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 WEST ST STE 250",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241786",
            "telephone_number": "585-208-9285",
            "fax_number": "585-208-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3170 WEST ST STE 250",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241786",
            "telephone_number": "585-394-3737",
            "fax_number": "585-394-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE DENTAL TEAM AT CANANDAIGUA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A",
        "authorized_official_last_name": "ANTETOMASO",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-394-3736",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harborside Dental Team at Canandaigua",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.