Planet Smile Partners Main Street Dentistry PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PLANET SMILE PARTNERS MAIN STREET DENTISTRY PLLC

Practice address

115 Main St Ste 200
Tuckahoe, NY 10707-2948

Phone

(914) 864-0464

NPI assigned

May 31, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Gary Heitzler, DDS

Title

Ceo

Phone

(914) 864-0464

Specialties & licenses 1

Addresses

Other names 1

• Ortho on Main Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brianna Nichole Hines, DDS

  • Pediatric Dentistry
  • Mahopac, NY
  • NPI 1598389678
  NPD (past)
• Tina Park, D.D.S.

  • Pediatric Dentistry
  • Newton, NJ
  • NPI 1265971048
  NPD (past)

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1750074209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105492340",
            "telephone_number": "914-864-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MAIN ST STE 200",
            "city": "TUCKAHOE",
            "state": "NY",
            "postal_code": "107072948",
            "telephone_number": "914-864-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANET SMILE PARTNERS MAIN STREET DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "HEITZLER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "914-864-0464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ortho on Main",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pain Care and Regenerative Solutions LLC
• Pain Rehab Physical Therapy LLC
• Parkway Medical Associate PLLC
• Angeli Pemberton, LMHC
• Frank P Petronella, DDS
• Katherine Porpora, RN
• Linda Gail Poulos, RN
• Kerry A Purtill, MD
• Mervyn Richardson, PHARMD
• Steven Rivera, ANP

• Orthodontics and Dentofacial Orthopedics Dentistry in Tuckahoe, NY
• Providers in Tuckahoe, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.