National Provider Identifier

Kenny Pan, DDS

Kenny Pan, DDS is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Rochester, NY and a listed phone number of (646) 267-9419.

NPI 1407591092Rochester, NYGeneral Practice Dentistry

Profile Overview

NPI
1407591092
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
April 28, 2022
Last Updated
January 20, 2025

Practice Location

  • 1580 Elmwood Ave
  • Rochester, NY 14620-3620

Phone: (646) 267-9419

Mailing Address

  • 1580 Elmwood Ave Ste 10
  • Rochester, NY 14620-3620

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1407591092
Entity Type
Individual
Last Name
Pan
First Name
Kenny
Name Prefix
Dr.
Credential
DDS
Mailing Street Address
1580 Elmwood Ave Ste 10
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14620-3620
Mailing Country
US
Mailing Phone
(646) 267-9419
Practice Street Address
1580 Elmwood Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14620-3620
Practice Country
US
Practice Phone
(646) 267-9419
Enumeration Date
April 28, 2022
Last Updated
January 20, 2025
Sex
Male
Sole Proprietor
Yes
Certification Date
January 20, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)