SUFFOLK PEDIATRIC DENTISTRY NPI 1598997900

NPI Information

NPI: 1598997900
Provider Name: SUFFOLK PEDIATRIC DENTISTRY
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
8 MEDICAL DR
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 928-8585
Get Directions

SUFFOLK PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Port Jefferson Station, NY. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. SUFFOLK PEDIATRIC DENTISTRY NPI is 1598997900. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8 MEDICAL DR
PORT JEFFERSON STATION, NY
ZIP 11776-601
Phone: (631) 928-8585
Fax: (631) 928-8861

The provider's authorized official is Robert Serino .
The authorized official title is President and has the following contact phone number (631) 928-8585.

The enumeration date for this NPI number is 8/18/2009 and was last updated on 8/18/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	1223X0400X	Dentist	Orthodontics and Dentofacial Orthopedics	No
2	124Q00000X	Dental Hygienist		No
3	1223P0221X	Dentist	Pediatric Dentistry	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01864713	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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