Individual provider Active NPI

Gerald Paik, DDS

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1205983392
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5575 Issued in AZ
Practice address
13822 N 35TH Dr
Suite #5
Phoenix, AZ 85053
Phone
(602) 375-2310
Fax
(602) 375-0716
NPI assigned
Jan 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 5575 AZ Primary

Addresses

Primary practice location

13822 N 35TH Dr
Suite #5
Phoenix, AZ 85053

Mailing address

13822 N 35TH Dr
Suite #5
Phoenix, AZ 85053
Phone (602) 375-2310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150731014311 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0547574881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paik and Patel Dental,PLLC Dentist 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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205983392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13822 N 35TH DR",
            "address_2": "SUITE #5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85053",
            "telephone_number": "602-375-2310",
            "fax_number": "602-375-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13822 N 35TH DR",
            "address_2": "SUITE #5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85053",
            "telephone_number": "602-375-2310",
            "fax_number": "602-375-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIK",
        "first_name": "GERALD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.