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NPI Code Detail

MEDICARE: SHAY MARKOVITCH DENTISTRY, PLLC

MEDICARE: SHAY MARKOVITCH DENTISTRY, PLLC
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
11223S0112XOral and Maxillofacial Surgery (Dentist)
21223E0200XEndodontics
31223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1689425100
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHAY MARKOVITCH DENTISTRY, PLLC
Provider Business Mailing Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-243-2320
Fax Number :
Provider Business Practice Location Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-243-2320
Fax Number :
Authorized Official
Title or Position : REGIONAL MANAGER
Name : ELIZABETH WORTHMAN
Credential :
Telephone Number : 845-901-0702
Provider Enumeration Date : 04/01/2024
Last Update Date : 10/21/2025

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Directions to “SHAY MARKOVITCH DENTISTRY, PLLC ” Practice Location

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