Shamus Gartley, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS043639 Issued in PA

Practice address

920 Wyoming Ave Ste 203
Forty Fort, PA 18704-3999

Phone

(570) 283-3611

NPI assigned

Jul 10, 2024

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1376380113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 CLARK ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187052331",
            "telephone_number": "570-704-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WYOMING AVE STE 203",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187043999",
            "telephone_number": "570-283-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTLEY",
        "first_name": "SHAMUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS043639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forty Fort Dental LLC
• Jeffrey Fremont, PHD
• Eric Frusciante, D.M.D.
• Kara Furman
• Kathleen Anne Garrity, R.D.
• Tiffani Gebhardt
• Geisinger Clinic
• Geisinger Wyoming Valley
• Charles Patrick Gelso, BS RPH
• Elizabeth Gernhardt, DO

• Periodontics in Forty Fort, PA
• Providers in Forty Fort, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.