Organization Active NPI

City Dental Service Provider, PLLC

  • Pediatric Dentistry
  • Scarsdale, NY
National Provider Identifier
1003757204
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CITY DENTAL SERVICE PROVIDER, PLLC
Practice address
777 White Plains Rd
Scarsdale, NY 10583-5000
Phone
(914) 472-9090
NPI assigned
Apr 2, 2026
Organization subpart
Yes
Parent organization
CITY DENTAL SERVICE PROVIDER, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charlotte V Dasch
Title
Sr. Director of Credentialing &PR
Phone
(504) 638-0303

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

777 White Plains Rd
Scarsdale, NY 10583-5000

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442
Phone (615) 678-0759

National Provider Directory

National Provider Directory
Tax ID family
City Dental Service Provider PLLC2 organizations share this tax ID, including this one
Part of
City Dental Service Provider PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

777 White Plains Rd
Scarsdale, NY 10583
Phone (914) 472-9090

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1003757204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 WHITE PLAINS RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835000",
            "telephone_number": "914-472-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY DENTAL SERVICE PROVIDER, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY DENTAL SERVICE PROVIDER, PLLC",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SR. DIRECTOR OF CREDENTIALING &PR",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.