Provider Demographics
NPI:1346664331
Name:YANEZ FONTENLA, VIRGINIA (DDS)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:YANEZ FONTENLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 B PARRISH STREET SUITE 140
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424
Mailing Address - Country:US
Mailing Address - Phone:585-394-4058
Mailing Address - Fax:585-394-6108
Practice Address - Street 1:229 B PARRISH STREET SUITE 140
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-394-4058
Practice Address - Fax:585-394-6108
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0597531223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist