Active NPI
Tiffany N. Jamison, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1063688349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 58097
- Practice address
- 6230 W Manchester Ave
Los Angeles, CA 90045-3801 - Phone
- (310) 412-9291
- NPI assigned
- May 6, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | P58992 | NY | |
| Dentist | 122300000X | 58097 | CA | Primary |
Addresses
Primary practice location
6230 W Manchester Ave
Los Angeles, CA 90045-3801
Mailing address
6230 W Manchester Ave
Los Angeles, CA 90045-3801
Phone (310) 412-9291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58097 | CA | MD | Dentist |
| P58992 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Polish Dental Center Midtown | Current | Accepting new patients | |
| Polish Dental Center Marietta LLC | Current | Accepting new patients | |
| Polish Dental Center Alpharetta LLC | Current | Accepting new patients | |
| Gwendolyn Kelly DDS & Assoc. | Dentist | Past | Accepting new patients |
| Lauren a. Mathews D.DS., Incorporated | Dentist | Past | Accepting new patients |
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Public Health Dentistry
- Alpharetta, GA
- NPI 1699380840
-
- Dental Clinic/Center
- Marietta, GA
- NPI 1538826359
-
- Public Health Dentistry
- Atlanta, GA
- NPI 1972118123
-
- Dentist
- Los Angeles, CA
- NPI 1558772723
-
- Dentist
- Westchester, CA
- NPI 1083271886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236729600000",
"number": "1063688349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6230 W MANCHESTER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900453801",
"telephone_number": "310-412-9291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6230 W MANCHESTER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900453801",
"telephone_number": "310-412-9291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMISON",
"first_name": "TIFFANY",
"middle_name": "N.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-06",
"last_updated": "2009-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "P58992",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.