National Provider Identifier
Jack Michael Dorkhom, D.M.D.
Jack Michael Dorkhom, D.M.D. is listed in the NPPES registry with a primary specialty of Dentist in Pittsford, NY and a listed phone number of (585) 586-8895.
Profile Overview
- NPI
- 1184831109
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- May 17, 2007
- Last Updated
- March 28, 2024
Practice Location
- 101 Sully'S Trl
- Building 10
- Pittsford, NY 14534
Phone: (585) 586-8895
Mailing Address
- 69A Monroe Ave
- Pittsford, NY 14534-1321
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1184831109
- Entity Type
- Individual
- Last Name
- Dorkhom
- First Name
- Jack
- Middle Name
- Michael
- Name Prefix
- Dr.
- Credential
- D.M.D.
- Mailing Street Address
- 69A Monroe Ave
- Mailing City
- Pittsford
- Mailing State
- NY
- Mailing ZIP Code
- 14534-1321
- Mailing Country
- US
- Mailing Phone
- (585) 586-2580
- Mailing Fax
- (585) 586-4924
- Practice Street Address
- 101 Sully'S Trl
- Practice Address Line 2
- Building 10
- Practice City
- Pittsford
- Practice State
- NY
- Practice ZIP Code
- 14534
- Practice Country
- US
- Practice Phone
- (585) 586-8895
- Practice Fax
- (585) 485-0817
- Enumeration Date
- May 17, 2007
- Last Updated
- March 28, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- March 28, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)