Healthcare Provider Details

I. General information

NPI: 1619863966
Provider Name (Legal Business Name): LUCAS JAMES RESNICK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 DEWEY AVE
ROCHESTER NY
14616-2520
US

IV. Provider business mailing address

3950 DEWEY AVE
ROCHESTER NY
14616-2520
US

V. Phone/Fax

Practice location:
  • Phone: 585-865-0684
  • Fax: 585-865-3212
Mailing address:
  • Phone: 585-865-0684
  • Fax: 585-865-3212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number065605
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: