National Provider Identifier
Mitchel Costa, D.D.S.
Mitchel Costa, D.D.S. is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Fairport, NY and a listed phone number of (585) 383-0840.
Profile Overview
- NPI
- 1245617448
- Provider Type
- Individual
- Primary Specialty
- General Practice Dentistry
- Enumeration Date
- April 27, 2015
- Last Updated
- October 23, 2023
Practice Location
- 2828 Baird RD
- Fairport, NY 14450-1247
Phone: (585) 383-0840
Specialties
- General Practice Dentistry (1223G0001X)
Full Record
- NPI
- 1245617448
- Entity Type
- Individual
- Last Name
- Costa
- First Name
- Mitchel
- Credential
- D.D.S.
- Mailing Street Address
- 2828 Baird RD
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-1247
- Mailing Country
- US
- Mailing Phone
- (585) 383-0840
- Mailing Fax
- (585) 383-0881
- Practice Street Address
- 2828 Baird RD
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-1247
- Practice Country
- US
- Practice Phone
- (585) 383-0840
- Practice Fax
- (585) 383-0881
- Enumeration Date
- April 27, 2015
- Last Updated
- October 23, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- October 23, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Dentistry (1223G0001X)