Healthcare Provider Details

I. General information

NPI: 1760397764
Provider Name (Legal Business Name): LANG DENTAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 LONG POND RD
ROCHESTER NY
14612-3073
US

IV. Provider business mailing address

543 LONG POND RD
ROCHESTER NY
14612-3073
US

V. Phone/Fax

Practice location:
  • Phone: 585-227-4190
  • Fax:
Mailing address:
  • Phone: 585-227-4190
  • Fax: 585-227-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSICA CHEVERTON LANG
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 434-665-0424