Healthcare Provider Details

I. General information

NPI: 1427217199
Provider Name (Legal Business Name): JOHN S. VORRASI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S CLINTON AVE BLDG H SUITE 125
ROCHESTER NY
14618
US

IV. Provider business mailing address

2400 S CLINTON AVE BLDG H SUITE 125
ROCHESTER NY
14618
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-9004
  • Fax:
Mailing address:
  • Phone: 585-275-9004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number58356
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number058356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: