Individual provider Active NPI

Gretchen De Vales

  • Dentist
  • Delray Beach, FL
National Provider Identifier
1063861607
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26197 Issued in FL
Practice address
2275 S Federal Hwy Ste 310
Delray Beach, FL 33483-3332
Phone
(561) 894-4299
NPI assigned
Jun 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DN26197 FL Primary

Addresses

Primary practice location

2275 S Federal Hwy Ste 310
Delray Beach, FL 33483-3332

Mailing address

2275 S Federal Hwy Ste 310
Delray Beach, FL 33483-3332
Phone (561) 894-4299

Other practice location 1

1201 NW 16th St
Miami, FL 33125-1624
Phone (305) 575-7000

Other practice location 2

1665 W 68th St Ste 201
Hialeah, FL 33014-4400
Phone (786) 615-4083

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
DN26197FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nobel Dental, PA Dentist PastSince Oct 30, 2022 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": "1465084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1063861607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 S FEDERAL HWY STE 310",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334833332",
            "telephone_number": "561-894-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 S FEDERAL HWY STE 310",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334833332",
            "telephone_number": "561-894-4299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 NW 16th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331251624",
            "country_code": "US",
            "telephone_number": "305-575-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1665 W 68th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330144400",
            "country_code": "US",
            "telephone_number": "786-615-4083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE VALES",
        "first_name": "GRETCHEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-05",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.