Individual provider Active NPI

Jason T Horn, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Elmira, NY
National Provider Identifier
1922087980
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
054822 Issued in NY
Practice address
440 E Water St
Elmira, NY 14901-3411
Phone
(607) 733-7163
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 55020 CA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 054822 NY Primary

Addresses

Primary practice location

440 E Water St
Elmira, NY 14901-3411

Mailing address

440 E Water St
Elmira, NY 14901-3411
Phone (607) 733-7163

Other practice location 1

5015 Santa Cruz Ave Unit 105
San Diego, CA 92107-3352
Phone (917) 880-1613

Other practice location 2

5015 Santa Cruz Ave Unit 105
San Diego, CA 92107-3352
Phone (917) 880-1613

Other practice location 3

51 W 86th St Apt 301
New York, NY 10024-3617
Phone (917) 880-1613

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

LicenseStateTypeSpecialty
054822NYMDOrthodontics and Dentofacial Orthopedic Dentist
55020CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Orthodontics PC Orthodontics and Dentofacial Orthopedics CurrentSince Aug 23, 2020 Accepting new patients
Orthodontic Associates of the Southern Tier P.C. Orthodontics and Dentofacial Orthopedics PastSince Aug 23, 2020 Accepting new patients

Locations

440 E Water St
Elmira, NY 14901
Phone (607) 733-7163

Organizations & group practices 2

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1922087980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013411",
            "telephone_number": "607-733-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013411",
            "telephone_number": "607-733-7163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5015 Santa Cruz Ave Unit 105",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921073352",
            "country_code": "US",
            "telephone_number": "917-880-1613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5015 Santa Cruz Ave Unit 105",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921073352",
            "country_code": "US",
            "telephone_number": "917-880-1613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 W 86th St Apt 301",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100243617",
            "country_code": "US",
            "telephone_number": "917-880-1613",
            "fax_number": "917-880-1613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORN",
        "first_name": "JASON",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "55020",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "054822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.