NPIMap

Organization Active NPI

Sprout Pediatric Dental

  • Pediatric Dentistry
  • Honesdale, PA
National Provider Identifier
1902525264
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SPROUT PEDIATRIC DENTAL
Practice address
177 Sunrise Ave
Honesdale, PA 18431-1027
Phone
(570) 253-0358
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 Aug 22, 2022

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

Authorized official

Name
Katherine Rosalie Schloesser, DMDNPI 1033373485
Title
DMD/Owner
Phone
(570) 253-0358

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

177 Sunrise Ave
Honesdale, PA 18431-1027

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
102769720-0001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://w.deliveryslip.com/sproutdental 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

177 Sunrise Ave
Honesdale, PA 18431
Phone (570) 253-0358

Practitioners & affiliated clinicians

Practitioners 3

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": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1902525264",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 SUNRISE AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311027",
            "telephone_number": "570-253-0358",
            "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": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHLOESSER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ROSALIE",
        "authorized_official_title_or_position": "DMD/OWNER",
        "authorized_official_telephone_number": "570-253-0358",
        "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": "102769720-0001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://w.deliveryslip.com/sproutdental",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure email",
            "address_1": "177 Sunrise Ave",
            "city": "Honesdale",
            "state": "PA",
            "country_code": "US",
            "postal_code": "184311027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.