Individual provider Active NPI

Calvin H Tam, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1316452717
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7001 Issued in NV
Practice address
2360 Broadway
New York, NY 10024-2801
Phone
(212) 406-3686
NPI assigned
Dec 7, 2017
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61008 NY
General Practice Dentistry 1223G0001X 7001 NV Primary

Addresses

Primary practice location

2360 Broadway
New York, NY 10024-2801

Mailing address

2220 Midvale Ter
Henderson, NV 89074-5343

Other practice location 1

6870 S Rainbow Blvd Ste 112
Las Vegas, NV 89118-2108
Phone (207) 909-2900

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

LicenseStateTypeSpecialty
7001NVMDGeneral Practice Dentistry
61008NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1316452717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 MIDVALE TER",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242801",
            "telephone_number": "212-406-3686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6870 S Rainbow Blvd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891182108",
            "country_code": "US",
            "telephone_number": "207-909-2900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAM",
        "first_name": "CALVIN",
        "middle_name": "H",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-07",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "61008",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.