Organization Active NPI

Sprout Pediatric Dental

  • Pediatric Dentistry
  • Kingston, PA
National Provider Identifier
1558080804
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SPROUT PEDIATRIC DENTAL
Practice address
541 Pierce St
Kingston, PA 18704
Phone
(267) 324-7933
Fax
(570) 352-3395
NPI assigned
Aug 22, 2022
Organization subpart
Yes
Parent organization
SPROUT PEDIATRIC DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Authorized official

Name
Dr. Katherine Rosalie Schloesser, DMD
Title
Pediatric Dentist
Phone
(570) 253-0358

Specialties & licenses 1

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

Addresses

Primary practice location

541 Pierce St
Kingston, PA 18704

Mailing address

554 Hamlin Hwy
Lake Ariel, PA 18436-9319
Phone (267) 324-7933

Other identifiers 1

IdentifierTypeStateIssuer
102769720-0008MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://account.appriver.com/identity/login?signin=1857a2b7b84022d4ee65b45e09fadfc6 Direct

National Provider Directory

National Provider Directory
Tax ID family
Sprout Pediatric Dental5 organizations share this tax ID, including this one
Part of
Sprout Pediatric Dental

Other organizations with this tax ID 4

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

Locations

541 Pierce St
Kingston, PA 18704
Phone (267) 324-7933

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1558080804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 HAMLIN HWY",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184369319",
            "telephone_number": "267-324-7933",
            "fax_number": "570-352-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "267-324-7933",
            "fax_number": "570-352-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT PEDIATRIC DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPROUT PEDIATRIC DENTAL",
        "enumeration_date": "2022-08-22",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "SCHLOESSER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ROSALIE",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "570-253-0358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102769720-0008",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://account.appriver.com/identity/login?signin=1857a2b7b84022d4ee65b45e09fadfc6",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email only",
            "address_1": "487 Northampton St",
            "city": "Kingston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187044509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.