Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Port Jefferson Dental Group P. C.

Organization General Practice Dentistry · NPI 1093960890

Port Jefferson Dental Group P. C. provides General Practice Dentistry in Port Jefferson, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008
Specialties on file
2

Practice location Address checks out

602 Main St
Port Jefferson, NY 11777-2203 Not confirmed with CMS for 17 years — call before visiting
Phone: (631) 473-0605
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 033761 (NY)
General Practice Dentistry Taxonomy 1223G0001X · Licence 051054 (NY)

Record details

NPI number1093960890
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Rutter — President · (631) 473-1511
NPI enumeratedNovember 20, 2008
Last updated in NPPESNovember 20, 2008
Mailing address602 Main St, Port Jefferson, NY 11777-2203

Other providers in Port Jefferson