Mussarat Pathan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.027443 Issued in OH

Practice address

210 Delaware St
Walton, NY 13856-1020

Phone

(607) 865-9330

Fax

(607) 865-6370

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1689780280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 DELAWARE ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561020",
            "telephone_number": "607-865-9330",
            "fax_number": "607-865-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 DELAWARE ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561020",
            "telephone_number": "607-865-9330",
            "fax_number": "607-865-6370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 N Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450668007",
            "country_code": "US",
            "telephone_number": "937-748-0940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHAN",
        "first_name": "MUSSARAT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047918",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.027443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01892460",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Huyen Nguyen, PMHNP-BC
• Nicole Gerace LCSW PLLC
• Dawn F. Northrup, REGISTERED NURSE / S
• Deanna O'Connor, LPN
• Leeann Otto
• Alexis Pawlewicz, PHARMD, RPH
• Jean Petterson, D.O.
• Hunter William Reed, DPT
• Robert Reynolds, PA
• Luis Francisco Rodriguez-Betancourt, MD

• General Practice Dentistry in Walton, NY
• Providers in Walton, 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 Oct 1, 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.