Provider Demographics
NPI:1134614688
Name:DVARISHKIS, NATHANIEL (DDS)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:DVARISHKIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:NATHANIEL
Other - Middle Name:
Other - Last Name:HOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:625 ELMWOOD AVE # 683
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2913
Mailing Address - Country:US
Mailing Address - Phone:585-275-5051
Mailing Address - Fax:
Practice Address - Street 1:625 ELMWOOD AVE # 683
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2913
Practice Address - Country:US
Practice Address - Phone:585-275-5051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program