MEDICARE: JASON ROBERT TANOORY DMD, FAGD

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
1	1223G0001X	General Practice Dentistry	050001-1	NY

General Provider Information

NPI Number	:	1982656344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ROBERT TANOORY DMD, FAGD

Provider Business Mailing Address
First Line	:	329 S MAIN ST
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-2118
Country	:	US
Telephone Number	:	585-394-1930
Fax Number	:	585-394-1938

Provider Business Practice Location Address
First Line	:	329 SOUTH MAIN STREET
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424
Country	:	US
Telephone Number	:	585-394-1930
Fax Number	:	585-394-1938

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	12/12/2025

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