Active NPI
Tamara Gordon
- Dentist
- York, PA
National Provider Identifier
1578053922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS042514
- Practice address
- 3013 E Market St Ste 100
York, PA 17402-2513 - Phone
- (914) 712-5999
- NPI assigned
- May 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 060845 | NY | |
| Dentist | 122300000X | DS042514 | PA | Primary |
Addresses
Primary practice location
3013 E Market St Ste 100
York, PA 17402-2513
Mailing address
3013 E Market St Ste 100
York, PA 17402-2513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060845 | NY | MD | Dentist |
| DS042514 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1578053922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3013 E MARKET ST STE 100",
"city": "YORK",
"state": "PA",
"postal_code": "174022513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3013 E MARKET ST STE 100",
"city": "YORK",
"state": "PA",
"postal_code": "174022513",
"telephone_number": "914-712-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "TAMARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-11",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "060845",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS042514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.