Provider Demographics
NPI:1689425100
Name:SHAY MARKOVITCH DENTISTRY, PLLC
Entity Type:Organization
Organization Name:SHAY MARKOVITCH DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-243-2320
Mailing Address - Street 1:4384 LAKEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-9761
Mailing Address - Country:US
Mailing Address - Phone:585-243-2320
Mailing Address - Fax:
Practice Address - Street 1:4384 LAKEVILLE RD
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-9761
Practice Address - Country:US
Practice Address - Phone:585-243-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAY MARKOVITCH DENTISTRY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-01
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty