Individual provider Active NPI

Michael Gusar, D.M.D.

  • General Practice Dentistry
  • Auburn, MA
National Provider Identifier
1114921723
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12547 Issued in MA
Practice address
184 Oxford St N
Auburn, MA 01501-1529
Phone
(508) 832-3205
Fax
(508) 832-8906
NPI assigned
Jun 10, 2005
Reactivated
Mar 20, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12547 MA Primary

Addresses

Primary practice location

184 Oxford St N
Auburn, MA 01501-1529

Mailing address

184 Oxford St N
Auburn, MA 01501-1529
Phone (508) 832-3205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150521000251 MA Order and Referring Only - DentistPractitioner - Dentist 9335469071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12547MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vivek Mehta DMD PC Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114921723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 OXFORD ST N",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015011529",
            "telephone_number": "508-832-3205",
            "fax_number": "508-832-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 OXFORD ST N",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015011529",
            "telephone_number": "508-832-3205",
            "fax_number": "508-832-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSAR",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2026-07-13",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "12547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, MA

Sources for this page

Verify at the official NPI Registry.