| Azita Anissi Dds | |
|
121 Sullys Trail Suite 1 Pittsford NY 14534 | |
| (585) 267-7745 | |
| (585) 267-7748 |
| Full Name | Azita Anissi Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 121 Sullys Trail Suite 1, Pittsford, New York |
| Authorized Official Name and Position | Azita Anissi (DENTIST) |
| Authorized Official Contact | 5852677745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Azita Anissi Dds 121 Sullys Trail Suite 1 Pittsford NY 14534 Ph: (585) 267-7745 | Azita Anissi Dds 121 Sullys Trail Suite 1 Pittsford NY 14534 Ph: (585) 267-7745 |
| NPI Number | 1619448990 |
|---|---|
| Provider Enumeration Date | 12/11/2018 |
| Last Update Date | 12/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619448990 | NPI | - | NPPES |
| 01343544 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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