=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225916539
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | G&G DENTAL GROUP PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2025
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2913 CULVER RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14622-2821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-467-7000
-----------------------------------------------------
Fax | 585-467-7000
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2913 CULVER RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14622-2821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-467-7000
-----------------------------------------------------
Fax | 585-467-7000
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. ALEXIS GHANEM AYOUBI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 585-503-0713
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------