Individual provider Active NPI

Michael B. Gale, DMD

  • Dentist
  • Newark, NJ
National Provider Identifier
1093936734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
012153 Issued in NJ
Practice address
164 Ferry St
Newark, NJ 07105-2158
Phone
(973) 589-5227
NPI assigned
May 1, 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
Dentist 122300000X 012153 NJ Primary

Addresses

Primary practice location

164 Ferry St
Newark, NJ 07105-2158

Mailing address

780 Oak Ave
Westfield, NJ 07090-2330
Phone (973) 589-5227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160323000545 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6608173463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012153NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093936734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 OAK AVE",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902330",
            "telephone_number": "973-589-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071052158",
            "telephone_number": "973-589-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALE",
        "first_name": "MICHAEL",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "012153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.