Individual provider Active NPI

Susanne M Gelb, D.D.S

  • General Practice Dentistry
  • Hartford, CT
National Provider Identifier
1174744726
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4622 Issued in CT
Practice address
86 Gillett St
Hartford, CT 06105-2629
Phone
(860) 247-5679
Fax
(860) 278-1104
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 4622 CT Primary

Addresses

Primary practice location

86 Gillett St
Hartford, CT 06105-2629

Mailing address

86 Gillett St
Hartford, CT 06105-2629
Phone (860) 247-5679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160519000869 CT Order and Referring Only - DentistPractitioner - Dentist 3577852250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4622CTMDPhysician Assistant

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": "1174744726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 GILLETT ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052629",
            "telephone_number": "860-247-5679",
            "fax_number": "860-278-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 GILLETT ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052629",
            "telephone_number": "860-247-5679",
            "fax_number": "860-278-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELB",
        "first_name": "SUSANNE",
        "middle_name": "M",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "4622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.