National Provider Identifier

Scott Richard Gergelis

Scott Richard Gergelis is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Fairport, NY and a listed phone number of (585) 223-8690.

NPI 1417585761Fairport, NYGeneral Practice Dentistry

Profile Overview

NPI
1417585761
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
March 31, 2020
Last Updated
December 11, 2024

Practice Location

  • 110 Cross Keys Office Park
  • Fairport, NY 14450-3509

Phone: (585) 223-8690

Mailing Address

  • 52 Chasewood Ln
  • East Amherst, NY 14051-1813

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1417585761
Entity Type
Individual
Last Name
Gergelis
First Name
Scott
Middle Name
Richard
Mailing Street Address
52 Chasewood Ln
Mailing City
East Amherst
Mailing State
NY
Mailing ZIP Code
14051-1813
Mailing Country
US
Mailing Phone
(716) 913-0193
Practice Street Address
110 Cross Keys Office Park
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-3509
Practice Country
US
Practice Phone
(585) 223-8690
Enumeration Date
March 31, 2020
Last Updated
December 11, 2024
Sex
Male
Sole Proprietor
Yes
Certification Date
December 11, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)