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KID SMILES PEDIATRIC DENTISTRY OF PORT JEFFERSON STATION PLLC
NPI 1144921602
Dentist - Pediatric Dentistry in Port Jefferson Station, NY

Active since March 13, 2023
1174 ROUTE 112 STE B, PORT JEFFERSON STATION, NY 11776(631) 676-4071(516) 588-9221 Get Directions Write a Review

NPPES record last updated: March 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kid Smiles Pediatric Dentistry Of Port Jefferson Station Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KID SMILES PEDIATRIC DENTISTRY OF PORT JEFFERSON STATION PLLC (NPI 1144921602) is a healthcare organization registered as a pediatric dentistry in Port Jefferson Station, New York and active in the NPI registry since March 2023. The organization lists Cynthia Lynn Pastore, Insurance Coordinator, as its authorized official.

NPPES Registry Identity

NPI1144921602
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameKID SMILES PEDIATRIC DENTISTRY OF PORT JEFFERSON STATION PLLC
Location Address1174 ROUTE 112 STE BPort Jefferson Station, NY 11776-8033
Mailing Address1174 Route 112 Ste BPort Jefferson Station, NY 11776-8033 · (631) 676-4071 · Fax (516) 588-9221
Phone(631) 676-4071
Fax(516) 588-9221
Organization SubpartNo
Authorized OfficialCynthia Lynn PastoreInsurance Coordinator · (516) 548-8753
Enumeration DateMarch 13, 2023
NPPES CertifiedMarch 13, 2023
✔ NPI 1144921602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
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.
1174 ROUTE 112 STE B, Port Jefferson Station, NY 11776
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Other Names 1

Doing Business AsKid Smiles Pediatric Dentistry Of Port Jefferson Station Pllc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kid Smiles Pediatric Dentistry Of Port Jefferson Station PLLC's NPI number?

The NPI number for Kid Smiles Pediatric Dentistry Of Port Jefferson Station PLLC is 1144921602. It was assigned to this organization in the NPPES registry on March 13, 2023.

Where is Kid Smiles Pediatric Dentistry Of Port Jefferson Station PLLC located?

Kid Smiles Pediatric Dentistry Of Port Jefferson Station PLLC is located at 1174 Route 112 Ste B, Port Jefferson Station, NY 11776. The listed phone number is (631) 676-4071.

What is Kid Smiles Pediatric Dentistry Of Port Jefferson Station PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Kid Smiles Pediatric Dentistry Of Port Jefferson Station PLLC was last updated on March 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.