Provider Demographics
NPI:1952929143
Name:SADEK, FADY (DMD)
Entity Type:Individual
Prefix:DR
First Name:FADY
Middle Name:
Last Name:SADEK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4121
Mailing Address - Country:US
Mailing Address - Phone:438-830-0226
Mailing Address - Fax:
Practice Address - Street 1:4660 VETERANS MEMORIAL DR # F1
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1298
Practice Address - Country:US
Practice Address - Phone:585-344-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist