Individual provider Active NPI

Gerald Jacob Kasper, D.M.D.

  • Dentist
  • Waymart, PA
National Provider Identifier
1033624770
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS027399L Issued in PA
Practice address
11 Farview Rd
Waymart, PA 18472-7700
Phone
(570) 488-5811
Fax
(570) 488-2500
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS027399L PA Primary

Addresses

Primary practice location

11 Farview Rd
Waymart, PA 18472-7700

Mailing address

20 Hillcrest Dr
Olyphant, PA 18447-1339
Phone (570) 650-5028

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
DS027399LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1033624770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HILLCREST DR",
            "city": "OLYPHANT",
            "state": "PA",
            "postal_code": "184471339",
            "telephone_number": "570-650-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FARVIEW RD",
            "city": "WAYMART",
            "state": "PA",
            "postal_code": "184727700",
            "telephone_number": "570-488-5811",
            "fax_number": "570-488-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPER",
        "first_name": "GERALD",
        "middle_name": "JACOB",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS027399L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waymart, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.