NPIMap

Organization Active NPI

Rossarin Mitsumoto D.D.S., P.C.

Doing business as Port Chester Kid Smiles

  • Pediatric Dentistry
  • Sleepy Hollow, NY
National Provider Identifier
1316467269
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
ROSSARIN MITSUMOTO D.D.S., P.C.
Doing business as
Port Chester Kid Smiles
Tappan Zee Kid Smiles
Practice address
245 N Broadway Ste 108
Sleepy Hollow, NY 10591-2657
Phone
(914) 332-1272
Fax
(914) 332-1261
NPI assigned
Jun 21, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Rossarin Mitsumoto, DDSNPI 1922238450
Title
Owner
Phone
(914) 332-1272

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

245 N Broadway Ste 108
Sleepy Hollow, NY 10591-2657

Mailing address

245 N Broadway Ste 108
Sleepy Hollow, NY 10591-2657
Phone (914) 332-1272

Other practice location 1

55 S Main St Ste 1A
Port Chester, NY 10573-4618
Phone (914) 939-2000

Other names 2

  • Port Chester Kid Smiles Doing business as
  • Tappan Zee Kid Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

245 N Broadway
Ste 108
Sleepy Hollow, NY 10591
Phone (914) 332-1272

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1316467269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N BROADWAY STE 108",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912657",
            "telephone_number": "914-332-1272",
            "fax_number": "914-332-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N BROADWAY STE 108",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912657",
            "telephone_number": "914-332-1272",
            "fax_number": "914-332-1261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 S Main St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Port Chester",
            "state": "NY",
            "postal_code": "105734618",
            "country_code": "US",
            "telephone_number": "914-939-2000",
            "fax_number": "914-939-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROSSARIN MITSUMOTO D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MITSUMOTO",
        "authorized_official_first_name": "ROSSARIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-332-1272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Chester Kid Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tappan Zee Kid Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sleepy Hollow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.