Healthcare Provider Details

I. General information

NPI: 1063335693
Provider Name (Legal Business Name): SMALL WORLD SMILES DENTISTRY
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

315 MEETING HOUSE LN
SOUTHAMPTON NY
11968-5051
US

IV. Provider business mailing address

315 MEETING HOUSE LN
SOUTHAMPTON NY
11968-5051
US

V. Phone/Fax

Practice location:
  • Phone: 631-204-5700
  • Fax:
Mailing address:
  • Phone: 631-204-5700
  • 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