MEDICARE: WEBSTER ORTHODONTICS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1538003173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBSTER ORTHODONTICS, PLLC

Provider Business Mailing Address
First Line	:	750 PITTSFORD VICTOR RD
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-3938
Country	:	US
Telephone Number	:	585-248-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 CROSSPOINTE LN STE B
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-2968
Country	:	US
Telephone Number	:	585-872-4660
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. CHERYL M PRATT
Credential	:
Telephone Number	:	585-872-4660

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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