Individual provider Active NPI

Timothy Ganfield, D.M.D.

  • General Practice Dentistry
  • Newark, DE
National Provider Identifier
1942329032
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17004 Issued in DE
Practice address
12 Polly Drummond Hill Rd
Newark, DE 19711-5703
Phone
(302) 731-4225
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 17004 DE Primary

Addresses

Primary practice location

12 Polly Drummond Hill Rd
Newark, DE 19711-5703

Mailing address

1096 Birch LN
Marcus Hook, PA 19061-1763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20150616001276 DE Order and Referring Only - DentistPractitioner - Dentist 4183935273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17004DEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
White Clay Dental Associates, P.a. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942329032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 BIRCH LN",
            "city": "MARCUS HOOK",
            "state": "PA",
            "postal_code": "190611763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 POLLY DRUMMOND HILL RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197115703",
            "telephone_number": "302-731-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANFIELD",
        "first_name": "TIMOTHY",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "17004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.