NPIMap

Organization Active NPI

Cedar Crest ENT Associates P.C.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Allentown, PA
National Provider Identifier
1073575973
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
MD022099E Issued in PA
Legal business name
CEDAR CREST ENT ASSOCIATES P.C.
Practice address
1251 S Cedar Crest Blvd
Suite 100
Allentown, PA 18103-6205
Phone
(610) 770-9797
Fax
(610) 770-9521
NPI assigned
Apr 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Dr. Theodore H Gaylor, M.D.
Title
M.D./President
Phone
(610) 770-9797

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X MD022099E PA
Pediatric Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YP0228X MD022099E PA
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0007X MD022099E PA Primary

Addresses

Primary practice location

1251 S Cedar Crest Blvd
Suite 100
Allentown, PA 18103-6205

Mailing address

1251 S Cedar Crest Blvd
Suite 100
Allentown, PA 18103-6205
Phone (610) 770-9797

Other identifiers 2

IdentifierTypeStateIssuer
02348200OtherPACAPITAL BLUE CROSS
0549870OtherPAAETNA US HEALTHCARE

National Provider Directory

National Provider Directory

Locations

1251 S Cedar Crest Blvd
Ste 100
Allentown, PA 18103
Phone (610) 770-9797

1251 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 439-1501

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1073575973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD",
            "address_2": "SUITE 100",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036205",
            "telephone_number": "610-770-9797",
            "fax_number": "610-770-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD",
            "address_2": "SUITE 100",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036205",
            "telephone_number": "610-770-9797",
            "fax_number": "610-770-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREST ENT ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "GAYLOR",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "M.D./PRESIDENT",
        "authorized_official_telephone_number": "610-770-9797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "PA",
            "license": "MD022099E",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "PA",
            "license": "MD022099E",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "PA",
            "license": "MD022099E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02348200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "0549870",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.