Healthcare Provider Details

I. General information

NPI: 1073568556
Provider Name (Legal Business Name): THOMAS EDWARD HELFST DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 E RIDGE RD
ROCHESTER NY
14621-2006
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-4103
  • Fax: 585-922-4495
Mailing address:
  • Phone: 585-922-0553
  • Fax: 585-922-0496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number045154
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS030923-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: