Individual provider Active NPI

Paulette P Porteous-Cole, D.D.S.

  • General Practice Dentistry
  • Port Chester, NY
National Provider Identifier
1053494112
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048220 Issued in NY
Practice address
5 Grace Church St
Port Chester, NY 10573-4911
Phone
(914) 937-8899
NPI assigned
Oct 23, 2006
Last updated
Jan 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 048220 NY Primary

Addresses

Primary practice location

5 Grace Church St
Port Chester, NY 10573-4911

Mailing address

165 Main St
Ossining, NY 10562-4702
Phone (914) 941-1263

Other identifiers 1

IdentifierTypeStateIssuer
01962587MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
048220NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1053494112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRACE CHURCH ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734911",
            "telephone_number": "914-937-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTEOUS-COLE",
        "first_name": "PAULETTE",
        "middle_name": "P",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01962587",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.