Provider Demographics
NPI:1285812636
Name:KEMSHETTI, MEGGY (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGGY
Middle Name:
Last Name:KEMSHETTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MEGGY
Other - Middle Name:A
Other - Last Name:ORELLANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2772 E HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9354
Mailing Address - Country:US
Mailing Address - Phone:585-486-4664
Mailing Address - Fax:585-486-4839
Practice Address - Street 1:2772 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9354
Practice Address - Country:US
Practice Address - Phone:585-486-4664
Practice Address - Fax:585-486-4839
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053749122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03038951Medicaid