Andrea Elizabeth Tannis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS044077 Issued in PA

Practice address

300 Lackawanna Ave
Scranton, PA 18503-2001

Phone

(570) 343-4472

NPI assigned

May 31, 2023

Sex

Female

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1790478287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N ABINGTON RD",
            "city": "WAVERLY TOWNSHIP",
            "state": "PA",
            "postal_code": "184112315",
            "telephone_number": "267-466-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LACKAWANNA AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185032001",
            "telephone_number": "570-343-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNIS",
        "first_name": "ANDREA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS044077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Gates Talarico, MS
• Sara Talarico, MED, LAT, ATC
• Stacey M Talbot, CRPNP
• Jayanth Reddy Tallapalli
• Brittany Lynn Tallarico, MS, OTR/L
• Kristina Tanovic, M.D.
• Shams Zerin Tasnim, M.D.
• Sarah Dorcas Taylor Conlon, BCABA
• Amanda Paige Taylor, NCC
• Andrew Allen Taylor, DDS

• Dentist in Scranton, PA
• Providers in Scranton, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.