Thomas M Doran, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-028142-L Issued in PA

Practice address

335 3Rd Ave
Kingston, PA 18704-5819

Phone

(570) 283-1750

Fax

(570) 283-1752

NPI assigned

Sep 1, 2005

Last updated

Jun 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1073507323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 3RD AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045819",
            "telephone_number": "570-283-1750",
            "fax_number": "570-283-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 3RD AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045819",
            "telephone_number": "570-283-1750",
            "fax_number": "570-283-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-028142-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012957250002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012957250003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Derby, LMT
• Aunisha Desai, PA-C
• Allison Difebo
• Dawn Dimaria, LSW
• Patti A. Dompkosky, RPH
• Thomas Francis Dougherty Jr., MS, LPC, NCP
• Catherine Douglas, LSW
• Dr. Brown's Children's Dental Center, PC
• Dragonette Chiropractic, LLC
• Ashley Dule

• General Practice Dentistry in Kingston, PA
• Providers in Kingston, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.