NPIMap

Organization Active NPI

Grace Dentisry, P.C.

  • Dental Clinic/Center
  • Port Jefferson, NY
National Provider Identifier
1356797674
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
053165-1 Issued in NY
Legal business name
GRACE DENTISRY, P.C.
Practice address
111 N Country Rd Ste 1
Port Jefferson, NY 11777-2605
Phone
(631) 473-4400
NPI assigned
May 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Authorized official

Name
Dr. Sara Grace, DDSNPI 1134595580
Title
Dentist
Phone
(631) 473-4400

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
Dental Clinic/Center 261QD0000X 053165-1 NY Primary

Addresses

Primary practice location

111 N Country Rd Ste 1
Port Jefferson, NY 11777-2605

Mailing address

111 N Country Rd Ste 1
Port Jefferson, NY 11777-2605
Phone (631) 473-4400

National Provider Directory

National Provider Directory

Locations

111 N Country Rd
Ste 1
Port Jefferson, NY 11777
Phone (631) 473-4400

Practitioners & affiliated clinicians

Practitioners 1

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": "1462406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1356797674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N COUNTRY RD STE 1",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772605",
            "telephone_number": "631-473-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N COUNTRY RD STE 1",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772605",
            "telephone_number": "631-473-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE DENTISRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-05",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "631-473-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "053165-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.