Healthcare Provider Details

I. General information

NPI: 1417870064
Provider Name (Legal Business Name): TINY SMILES DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 LENOX AVE
NEW YORK NY
10027-5755
US

IV. Provider business mailing address

14 GLEN COVE RD
ROSLYN HEIGHTS NY
11577-1732
US

V. Phone/Fax

Practice location:
  • Phone: 646-970-3878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SETH NEWMAN
Title or Position: DOCTOR
Credential:
Phone: 732-636-3900