Active NPI
Genevieve Gagnon, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Newark, NJ
National Provider Identifier
1730276510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DI022118
- Practice address
- 925 Alling Street
Dental Health Associates PA
Newark, NJ 07102 - Phone
- (973) 297-1550
- Fax
- (973) 297-1554
- NPI assigned
- Oct 5, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DI022118 | NJ | Primary |
Addresses
Primary practice location
925 Alling Street
Dental Health Associates PA
Newark, NJ 07102
Mailing address
320 South Main Street
Corporate Office 2ND FLR
Philipsburg, NJ 08865
Phone (908) 387-6120
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
| License | State | Type | Specialty |
|---|---|---|---|
| DI022118 | NJ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730276510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 SOUTH MAIN STREET",
"address_2": "CORPORATE OFFICE 2ND FLR",
"city": "PHILIPSBURG",
"state": "NJ",
"postal_code": "08865",
"telephone_number": "908-387-6120",
"fax_number": "908-387-8322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 ALLING STREET",
"address_2": "DENTAL HEALTH ASSOCIATES PA",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07102",
"telephone_number": "973-297-1550",
"fax_number": "973-297-1554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNON",
"first_name": "GENEVIEVE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NJ",
"license": "DI022118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
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.