Nicholas Frandy Gardner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052233 Issued in NY

Practice address

119 E Main St
Gouverneur, NY 13642-1408

Phone

(315) 287-7900

Fax

(315) 287-4789

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nicholas Frandy Gardner

  • Oral and Maxillofacial Surgery (Dentist)
  • Gouverneur, NY
  • NPI 1811514508
  NPD Authorized official

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891720280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E MAIN ST",
            "address_2": "PO BOX 374",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421408",
            "telephone_number": "315-287-7900",
            "fax_number": "315-287-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E MAIN ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421408",
            "telephone_number": "315-287-7900",
            "fax_number": "315-287-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "NICHOLAS",
        "middle_name": "FRANDY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02682337",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward John Noble Hospital of Gouverneur Ny
• Edward John Noble Hospital of Gouverneur Ny Swing Bed Unit
• Robin L Einbinder
• Ej Noble Medical Professional Group
• Byron Evans, PA
• Tejla Marie Giles, PHARM D
• Juliann Goodfriend
• Gouverneur Central School
• Gouverneur Central School
• Gouverneur Central School

• General Practice Dentistry in Gouverneur, NY
• Providers in Gouverneur, NY by specialty
• General Practice Dentistry in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.