Individual provider Active NPI

Mariam Gawargi, D.M.D

  • Dentist
  • Easton, PA
National Provider Identifier
1992040760
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS042603 Issued in PA
Practice address
1101 Northampton St Ste 102
Easton, PA 18042-4152
Phone
(201) 527-0272
NPI assigned
Dec 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02510000 NJ
Dentist 122300000X DS042603 PA Primary

Addresses

Primary practice location

1101 Northampton St Ste 102
Easton, PA 18042-4152

Mailing address

635 E Broad St
Bethlehem, PA 18018-6332

Other practice location 1

160 Hamilton St
Allentown, PA 18101-1948
Phone (610) 984-1380

Other practice location 2

635 E Broad St
Bethlehem, PA 18018-6332
Phone (610) 984-1380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20221205000387 PA Practitioner - Dentist 9133598790 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02510000NJMDDentist
DS042603PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Centers of the Lehigh Valley Dentist CurrentSince Aug 19, 2022 Accepting new patients
Neighborhood Health Centers of the Lehigh Valley Current Accepting new patients

Locations

160 Hamilton St
Allentown, PA 18101
Phone (610) 477-0105

635 E Broad St
Bethlehem, PA 18018
Phone (610) 820-7605

1101 Northampton St
Ste 102
Easton, PA 18042
Phone (484) 544-3113

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": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1992040760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 E BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NORTHAMPTON ST STE 102",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180424152",
            "telephone_number": "201-527-0272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Hamilton St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181011948",
            "country_code": "US",
            "telephone_number": "610-984-1380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180186332",
            "country_code": "US",
            "telephone_number": "610-984-1380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAWARGI",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-05",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02510000",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.