NPIMap

Organization Active NPI

Pocono Kids Dental

  • Dental Clinic/Center
  • East Stroudsburg, PA
National Provider Identifier
1164590998
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
POCONO KIDS DENTAL
Practice address
175 E Brown St Ste 114
East Stroudsburg, PA 18301-3098
Phone
(570) 476-3506
Fax
(570) 421-9014
NPI assigned
Dec 1, 2006
Organization subpart
Yes
Parent organization
POCONO MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Thomas Marchozzi
Title
Sr VP & Cfo
Phone
(484) 862-3943

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

175 E Brown St Ste 114
East Stroudsburg, PA 18301-3098

Mailing address

206 E Brown St
East Stroudsburg, PA 18301-3006
Phone (570) 420-4938

Other names 1

  • Lehigh Valley Hospital Pocono Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pocono General Surgery28 organizations share this tax ID, including this one
Part of
Pocono General Surgery

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1164590998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-420-4938",
            "fax_number": "570-420-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E BROWN ST STE 114",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013098",
            "telephone_number": "570-476-3506",
            "fax_number": "570-421-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONO KIDS DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POCONO MEDICAL CENTER",
        "enumeration_date": "2006-12-01",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "MARCHOZZI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "SR VP & CFO",
        "authorized_official_telephone_number": "484-862-3943"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lehigh Valley Hospital Pocono",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.