Individual provider Active NPI

Judy Tam

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1902472285
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
062588 Issued in NY
Practice address
81 W 115TH St
New York, NY 10026-3138
Phone
(212) 426-0088
NPI assigned
May 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 062588 NY Primary

Addresses

Primary practice location

81 W 115TH St
New York, NY 10026-3138

Mailing address

81 W 115TH St
New York, NY 10026-3138

Other practice location 1

125 Walker St
New York, NY 10013-4135
Phone (212) 226-9339

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240229002321 NY Practitioner - Dentist 6002284064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062588NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthcare Network, Inc. CurrentSince Jan 21, 2024 Accepting new patients
Community Healthcare Network Inc CurrentSince Jan 21, 2024 Accepting new patients
Community Healthcare Network Inc Current Accepting new patients

Locations

1002 Westchester Ave
Bronx, NY 10459
Phone (718) 320-4466

999 Blake Ave
Brooklyn, NY 11208
Phone (718) 277-8303

8944 164th St
Jamaica, NY 11432
Phone (718) 523-2123

44 W 28th St
Fl 5
New York, NY 10001
Phone (212) 545-2439

60 Madison Ave
Fl 5
New York, NY 10010
Phone (212) 545-2400

81 W 115th St
New York, NY 10026
Phone (212) 426-0088

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1902472285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 W 115TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 W 115TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263138",
            "telephone_number": "212-426-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Walker St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100134135",
            "country_code": "US",
            "telephone_number": "212-226-9339",
            "fax_number": "212-226-2289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAM",
        "first_name": "JUDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.