1. Home
  2. Directory
  3. New York
  4. Brockport
  5. Dentist
  6. NPI Profile

BROCKPORT DENTAL PLLC
NPI 1114658614
Dentist - General Practice in Brockport, NY

Active since June 23, 2022
1000 TRANSIT WAY # 200, BROCKPORT, NY 14420(585) 957-0981 Get Directions Write a Review

NPPES record last updated: June 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brockport Dental Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROCKPORT DENTAL PLLC (NPI 1114658614) is a healthcare organization registered as a general practice in Brockport, New York and active in the NPI registry since June 2022. The organization lists Alexis Ghanem Ayoubi, President, as its authorized official.

NPPES Registry Identity

NPI1114658614
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBROCKPORT DENTAL PLLC
Location Address1000 TRANSIT WAY # 200Brockport, NY 14420-3008
Mailing Address9 Waterbury LnRochester, NY 14625-1361 · (585) 503-0713
Phone(585) 957-0981
Organization SubpartNo
Authorized OfficialAlexis Ghanem AyoubiPresident · (585) 503-0713
Enumeration DateJune 23, 2022
NPPES CertifiedJune 23, 2022
✔ NPI 1114658614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1000 TRANSIT WAY # 200, Brockport, NY 14420
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brockport Dental PLLC's NPI number?

The NPI number for Brockport Dental PLLC is 1114658614. It was assigned to this organization in the NPPES registry on June 23, 2022.

Where is Brockport Dental PLLC located?

Brockport Dental PLLC is located at 1000 Transit Way # 200, Brockport, NY 14420. The listed phone number is (585) 957-0981.

What is Brockport Dental PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Brockport Dental PLLC was last updated on June 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.