National Provider Identifier
Pedersen Dentistry, PLLC
Pedersen Dentistry, PLLC is listed in the NPPES registry with a primary specialty of Dentist in Rochester, NY and a listed phone number of (585) 473-3880.
Profile Overview
- NPI
- 1679231591
- Provider Type
- Organization
- Primary Specialty
- Dentist
- Enumeration Date
- December 08, 2021
- Last Updated
- December 08, 2021
Practice Location
- 400 Westfall RD
- Rochester, NY 14620-4606
Phone: (585) 473-3880
Mailing Address
- 18 Alameda Dr
- Fairport, NY 14450-8790
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1679231591
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Pedersen Dentistry, PLLC
- Mailing Street Address
- 18 Alameda Dr
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-8790
- Mailing Country
- US
- Practice Street Address
- 400 Westfall RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-4606
- Practice Country
- US
- Practice Phone
- (585) 473-3880
- Enumeration Date
- December 08, 2021
- Last Updated
- December 08, 2021
- Authorized Official Last Name
- Pedersen
- Authorized Official First Name
- Todd
- Authorized Official Middle Name
- Richard
- Authorized Official Title
- Member
- Authorized Official Phone
- (585) 469-5433
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Dr.
- Authorized Official Credential Text
- DDS
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- December 08, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)