BROCKPORT DENTAL PLLC
NPI 1114658614
Dentist - General Practice in Brockport, NY
NPI Status: Active since June 23, 2022
Contact Information
1000 TRANSIT WAY # 200
BROCKPORT, NY
ZIP 14420
Phone: (585) 957-0981
- Organization
- Dentist
- General Practice
- CLIA Number: 33D2177268
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-07-2028
About BROCKPORT DENTAL PLLC
This page provides the complete NPI Profile along with additional information for Brockport Dental Pllc, a provider established in Brockport, New York operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1114658614 assigned on June 2022. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Alexis Ghanem Ayoubi Dds (President)
- NPI
- 1114658614
- Provider Name
- BROCKPORT DENTAL PLLC
- Entity Type
- Organization
- Location Address
- 1000 TRANSIT WAY # 200 BROCKPORT, NY 14420
- Location Phone
- (585) 957-0981
- Mailing Address
- 9 WATERBURY LN ROCHESTER, NY 14625
- Mailing Phone
- (585) 503-0713
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-23-2022
- Last Update Date
- 06-23-2022
- Code Navigator
A dentist like Brockport Dental Pllc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 33D2177268
- Facility Type
- Physician Office
- Certificate Effective Date
- January 08, 2026
- Certificate Expiration Date
- January 07, 2028
- Laboratory Director
- DR. ALEX I. FAHOURY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Brockport Dental Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1114658614, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114658614, enumerated as an "organization" on June 23, 2022.
The provider is located at 1000 TRANSIT WAY # 200 BROCKPORT, NY 14420 and the phone number is (585) 957-0981.
Dentist with taxonomy code 1223G0001X and a focus in General Practice.
