Organization Active NPI

Pediatric Dentistry & Orthodontics, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Midland Park, NJ
National Provider Identifier
1245341981
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
PEDIATRIC DENTISTRY & ORTHODONTICS, LLC
Practice address
6 Prospect St
Suite 1a
Midland Park, NJ 07432-1606
Phone
(201) 445-5555
Fax
(201) 445-5057
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Carmine Carlo Russo, DMD, MSNPI 1295846921
Title
General Partner
Phone
(201) 445-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

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

Addresses

Primary practice location

6 Prospect St
Suite 1a
Midland Park, NJ 07432-1606

Mailing address

6 Prospect St
Suite 1a
Midland Park, NJ 07432-1606
Phone (201) 445-5555

Other names 1

  • Pediatric Dentistry of Midland Park Doing business as

National Provider Directory

National Provider Directory

Locations

6 Prospect St
Ste 1A
Midland Park, NJ 07432
Phone (201) 445-5555

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1245341981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PROSPECT ST",
            "address_2": "SUITE 1A",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321606",
            "telephone_number": "201-445-5555",
            "fax_number": "201-445-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PROSPECT ST",
            "address_2": "SUITE 1A",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321606",
            "telephone_number": "201-445-5555",
            "fax_number": "201-445-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY & ORTHODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "CARMINE",
        "authorized_official_middle_name": "CARLO",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "201-445-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry of Midland Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.