Provider Demographics
NPI:1851599781
Name:JOSEPH V. QUEVEDO, D.D.S., P.C.
Entity Type:Organization
Organization Name:JOSEPH V. QUEVEDO, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:QUEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:585-256-2200
Mailing Address - Street 1:2425 CLOVER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4517
Mailing Address - Country:US
Mailing Address - Phone:585-256-2200
Mailing Address - Fax:585-256-0443
Practice Address - Street 1:2425 CLOVER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4517
Practice Address - Country:US
Practice Address - Phone:585-256-2200
Practice Address - Fax:585-256-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047178-11223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty