Provider Demographics
NPI:1013123801
Name:PEDIATRIC DENTAL CARE OF WESTCHESTER, P.C.
Entity Type:Organization
Organization Name:PEDIATRIC DENTAL CARE OF WESTCHESTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAGWATI
Authorized Official - Middle Name:J
Authorized Official - Last Name:MISTRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MDS
Authorized Official - Phone:914-631-2134
Mailing Address - Street 1:11 BEECH LN
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3001
Mailing Address - Country:US
Mailing Address - Phone:914-631-2134
Mailing Address - Fax:914-524-9021
Practice Address - Street 1:11 BEECH LN
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-3001
Practice Address - Country:US
Practice Address - Phone:914-332-4070
Practice Address - Fax:914-524-9021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0345561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty