Healthcare Provider Details

I. General information

NPI: 1316871908
Provider Name (Legal Business Name): SMALL TO TALL DENTISTRY AND ORTHODONTICS CHILI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3171 CHILI AVE STE 400
ROCHESTER NY
14624-5440
US

IV. Provider business mailing address

3171 CHILI AVE STE 400
ROCHESTER NY
14624-5440
US

V. Phone/Fax

Practice location:
  • Phone: 585-889-1290
  • Fax:
Mailing address:
  • Phone: 585-889-1290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ANTHONY MOLISANI
Title or Position: MEMBER
Credential: DDS
Phone: 585-727-3538