JOSEPH J FANTUZZO (NPI# 1073620373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073620373 |
| Entity Type | Individual |
| Full Name | JOSEPH J FANTUZZO |
| Credential | D.D.S, M.D. |
| Practice Address |
601 Elmwood Ave Box 705 Rochester NY 14642-0001 |
| Practice Telephone | 5852755084 |
| Practice Fax Number | 5852760293 |
| Mailing Telephone | 5852755084 |
| Mailing Fax Number | 5852760293 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
043604 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PREFERRED CARE | MDJ123 | 01 | |
| NY | 02636886 | 05 |
| Street Address |
601 ELMWOOD AVE BOX 705 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14642-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324317 | Marc Norman Berliant | Internal Medicine | 601 Elmwood Ave, Box Med, Rochester, NY 14642-0001 | 2005-05-23 |
| 1386245165 | Stephanie Pilat | Pharmacist | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-11-06 |
| 1396346276 | Noah Ritzel | Physician Assistant | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-11-05 |
| 1811598790 | Natalie Tanke | Registered Nurse | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-11-05 |
| 1891394490 | Muhamed Ahmic | Nurse Anesthetist, Certified Registered | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-10-23 |
| 1619576543 | Patricia Marie Reiber | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0002 | 2020-10-21 |
| 1528667557 | Alexandra Jessie Strutt | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-10-21 |
| 1750989323 | Sarah Jones | Physician Assistant | 601 Elmwood Ave, Rochester, NY 14642-0002 | 2020-10-15 |
| 1679171334 | Audrey Linn Schroeder | Genetic Counselor, MS | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-10-15 |
| 1013515568 | Carla Katherine Muranyi | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0002 | 2020-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679192363 | Nicholas Campbell Love | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave, Ac-5, General Medicine Clinic 696, Rochester, NY 14642 | 2020-04-13 |
| 1750900650 | Phillip Braun | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave, Ac-5 General Medicine Clinic 696, Rochester, NY 14642 | 2020-04-10 |
| 1437786993 | Andrew Jeong | Student in an Organized Health Care Education/Training Program | Department of Orthopaedics and Rehabilitation, 601 Elmwood Avenue, Rochester, NY 14642 | 2020-03-25 |
| 1497227094 | Alison Kent | Pediatrics | Dept of Pediatrics, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642 | 2018-12-20 |
| 1326539909 | Saumya Goel Aujla | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # 664, Rochester, NY 14642 | 2018-05-19 |
| 1922505387 | Daniel Bral | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # 655, Rochester, NY 14642 | 2018-04-11 |
| 1194222513 | Jonah Meyerhoff | Student in an Organized Health Care Education/Training Program | 300 Crittenden Blvd Department of Psychiatry, Rochester, NY 14642 | 2018-04-11 |
| 1144738949 | Francis Michael Manzo | Registered Nurse | University of Rochester 601 Elmwood Ave Box Surg, Rochester, NY 14642 | 2018-01-15 |
| 1225552649 | George Norman Abraham | Internal Medicine | 600 Elmwood Avenue, University of Rochester, Rochester, NY 14642 | 2017-07-27 |
| 1861928301 | Sonia Thakur | Student in an Organized Health Care Education/Training Program | 601 Elmwood University of Rochester Medical Center, Department of Physicial Medicine and Rehabilitation, Rochester, NY 14642 | 2017-05-03 |
| Find all providers in zip 14642 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477991677 | Pooja Gangwani | Dentist | 2400 S Clinton Ave Ste 125, Rochester, NY 14618-2668 | 2013-06-10 |
| 1003137381 | Marc G. Johnson | Dentist | 150 Lynnwood Dr, Rochester, NY 14618-2826 | 2010-06-21 |
| 1427217199 | John S. Vorrasi | Dentist | 2400 S Clinton Ave Bldg H Suite 125, Rochester, NY 14618 | 2008-06-06 |
| 1992842793 | Antonia Kolokythas | Dentist | 601 Elmwood Ave Box 705, Rochester, NY 14642-0001 | 2007-01-31 |
| 1619022449 | Jolly M Caplash | Dentist | 10 Hagen Dr Ste 230, Rochester, NY 14625-2659 | 2007-01-24 |
| 1649215328 | Joel C Michelson | Dentist | 3632 10th Ln Nw, Rochester, MN 55901-6917 | 2006-06-18 |
| 1083681928 | Nicholas H. Psimos | Dentist | 1101 N Broadway, Rochester, MN 55906-6841 | 2006-02-28 |
| 1962482562 | Michael Kim Ban | Dentist | 450 Adams St, Rochester, PA 15074-1911 | 2006-01-19 |
| 1992794218 | Lee Cain Chewning | Dentist | 191 S Park St, Rochester, PA 15074-2217 | 2005-10-19 |
| 1033731815 | Shayla Camille Steeds | Dentist | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-05-14 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.