Healthcare Provider Details

I. General information

NPI: 1225836166
Provider Name (Legal Business Name): TRISTAN COLE YATES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 MARSH RD STE 4
PITTSFORD NY
14534-1655
US

IV. Provider business mailing address

271 MARSH RD STE 4
PITTSFORD NY
14534-1655
US

V. Phone/Fax

Practice location:
  • Phone: 585-586-3840
  • Fax: 585-586-3896
Mailing address:
  • Phone: 585-586-3840
  • Fax: 585-586-3896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number065512
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: