Individual provider Active NPI

Alyssa Beth Garin, DMD

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1265678445
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS029380L Issued in PA
Practice address
1620 Oregon Ave
Philadelphia, PA 19145
Phone
(215) 336-6868
Fax
(215) 336-8088
NPI assigned
Dec 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS029380L PA Primary

Addresses

Primary practice location

1620 Oregon Ave
Philadelphia, PA 19145

Mailing address

1620 Oregon Ave
Philadelphia, PA 19145
Phone (215) 336-6868

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151106001282 PA Order and Referring Only - DentistPractitioner - Dentist 9830409630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS029380LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1265678445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 OREGON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19145",
            "telephone_number": "215-336-6868",
            "fax_number": "215-336-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 OREGON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19145",
            "telephone_number": "215-336-6868",
            "fax_number": "215-336-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARIN",
        "first_name": "ALYSSA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS029380L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.