Provider Demographics
NPI:1104169523
Name:SOBEY, KAMI
Entity type:Individual
Prefix:
First Name:KAMI
Middle Name:
Last Name:SOBEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424
Mailing Address - Country:US
Mailing Address - Phone:585-394-1930
Mailing Address - Fax:585-394-1938
Practice Address - Street 1:329 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-394-1930
Practice Address - Fax:585-394-1938
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057301-11223G0001X
NY39200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program