Provider Demographics
NPI:1932295789
Name:AMBORSKI, JAMES D (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:AMBORSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 OFFICE PARK WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534
Mailing Address - Country:US
Mailing Address - Phone:585-586-9063
Mailing Address - Fax:585-586-1478
Practice Address - Street 1:30 OFFICE PARK WAY
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534
Practice Address - Country:US
Practice Address - Phone:585-586-9063
Practice Address - Fax:585-586-1478
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0430011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMD484POtherPREFERRED CARE
NY7764OtherBCBS MEDICAL AND DENTAL
NYPO10043001OtherBLUE CHOICE
U21405Medicare UPIN
NYPO10043001OtherBLUE CHOICE