Kathryn Demetra Mirras, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

058011 Issued in NY

Practice address

384 Montauk Hwy
Wainscott, NY 11975-2000

Phone

(631) 537-6364

NPI assigned

May 21, 2014

Last updated

Jan 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1346652690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 MONTAUK HWY",
            "city": "WAINSCOTT",
            "state": "NY",
            "postal_code": "119752000",
            "telephone_number": "631-537-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 MONTAUK HWY",
            "city": "WAINSCOTT",
            "state": "NY",
            "postal_code": "119752000",
            "telephone_number": "631-537-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRRAS",
        "first_name": "KATHRYN",
        "middle_name": "DEMETRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Mancuso
• Silvia McDaniel
• Casey Finn McGowin, RN, NP
• Merritt B White DO PC (Bridgehampton Family Medical Practice)
• Mahogany Miles, D.M.D.
• Ronit Reguer, LCSW
• Jason Marc Rudolph, PSY.D.
• Jason Taylor Schwartz, D.O.
• Rebecca L Sieger, DMD
• Ancy Verdier, DMD

• General Practice Dentistry in Wainscott, NY
• Providers in Wainscott, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.