Individual provider Active NPI

Michael W. Gable, D.D.S,

  • Dentist
  • San Diego, CA
National Provider Identifier
1073769576
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
57576 Issued in CA
Practice address
9855 Erma Rd
Suite 138
San Diego, CA 92131-3001
Phone
(858) 549-9688
Fax
(858) 549-7103
NPI assigned
Aug 15, 2008
Last updated
Aug 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 57576 CA Primary

Addresses

Primary practice location

9855 Erma Rd
Suite 138
San Diego, CA 92131-3001

Mailing address

9855 Erma Rd
Suite 138
San Diego, CA 92131-3001
Phone (858) 549-9688

Other names 1

  • Michael William Gable Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 26, 2016 through Apr 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
57576CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1073769576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9855 ERMA RD",
            "address_2": "SUITE 138",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313001",
            "telephone_number": "858-549-9688",
            "fax_number": "858-549-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 ERMA RD",
            "address_2": "SUITE 138",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313001",
            "telephone_number": "858-549-9688",
            "fax_number": "858-549-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABLE",
        "first_name": "MICHAEL",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "GABLE",
            "middle_name": "WILLIAM",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.