Provider Demographics
NPI:1710187620
Name:ZAHAVI, THOMAS (DMD MS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:ZAHAVI
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 SOUTH CLINTON AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-685-2005
Mailing Address - Fax:585-685-2003
Practice Address - Street 1:1815 SOUTH CLINTON AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-473-7600
Practice Address - Fax:585-473-7653
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05352111223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics