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NPI Code Detail

MEDICARE: JACQUELINE CHOW DDS

MEDICARE: JACQUELINE CHOW DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramNY
2122300000XDentist38780TX

General Provider Information

NPI Number : 1437884749
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE CHOW DDS
Provider Business Mailing Address
First Line : 625 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-2913
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 625 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-2913
Country : US
Telephone Number : 585-275-5051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2022
Last Update Date : 04/27/2026

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