Healthcare Provider Details

I. General information

NPI: 1710950605
Provider Name (Legal Business Name): ROCCO JOSEPH ODDO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2887 ELMWOOD AVE
KENMORE NY
14217-1326
US

IV. Provider business mailing address

225 HOPKINS RD
WILLIAMSVILLE NY
14221-3437
US

V. Phone/Fax

Practice location:
  • Phone: 716-877-2275
  • Fax:
Mailing address:
  • Phone: 716-633-8108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number047522
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number047522
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: