Provider Demographics
NPI:1215364583
Name:DANIEL J LIVINGSTON DDS PC
Entity Type:Organization
Organization Name:DANIEL J LIVINGSTON DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-334-8350
Mailing Address - Street 1:2104 E HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4518
Mailing Address - Country:US
Mailing Address - Phone:585-334-8350
Mailing Address - Fax:585-334-0390
Practice Address - Street 1:2104 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4518
Practice Address - Country:US
Practice Address - Phone:585-334-8350
Practice Address - Fax:585-334-0390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0371001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty