Active NPI
Anthony Guy Gambone, DMD BA
- Dentist
- Youngstown, OH
National Provider Identifier
1396965695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30014943
- Practice address
- 813 Catalina Ave
Youngstown, OH 44510-1206 - Phone
- (330) 747-9051
- NPI assigned
- Apr 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30014943 | OH | Primary |
| Dentist | 122300000X | 4381 | KY |
Addresses
Primary practice location
813 Catalina Ave
Youngstown, OH 44510-1206
Mailing address
813 Catalina Ave
Youngstown, OH 44510-1206
Phone (330) 747-9051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0640524 | Medicaid | OH |
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4381 | KY | MD | Dentist |
| 30014943 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396965695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 CATALINA AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445101206",
"telephone_number": "330-747-9051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 CATALINA AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445101206",
"telephone_number": "330-747-9051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBONE",
"first_name": "ANTHONY",
"middle_name": "GUY",
"name_prefix": "Dr.",
"credential": "DMD BA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30014943",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "4381",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0640524",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.