Tamika K Anoia, DDS
Individual provider Active NPI General Practice Dentistry · Queensbury, NY
NPI 1194051045 · NPPES record last updated Oct 28, 2009
Key facts
- NPI
- 1194051045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 54630 (NY)
- Practice address
- 1St Advantage Dental
1092 Rte 9
Queensbury, NY 12804-0382 - Phone
- (518) 798-9561
- NPI assigned
- Oct 28, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160330002015 | NY | Order and Referring Only - Dentist |
0749587152 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54630 | NY | MD | General Practice Dentistry |
| 054630 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Area Hudson Valley New York Dental PC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 54630 | NY | Yes |
Addresses
Primary practice location
1St Advantage Dental
1092 Rte 9
Queensbury, NY 12804-0382
Mailing address
PO Box 4382
Queensbury, NY 12804-0382
Phone (518) 798-9561
Other providers in Queensbury, NY
- Mary Anne Allen
- Rene E Allen
- Jessica Paige Amoroso
- Julie Anderson
- Louise Margarette Andre-Joseph
- Aaron Joshua Antiles
- Elizabeth Akua Apraku
- Suzanne Aproian-Bendick
- Cynthia M Arberger
- Theresa Marie Arcuri
All providers in Queensbury, NY · General Practice Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.