Individual provider Active NPI

Nancy Gergis, DDS

  • Dentist
  • Newark, NJ
National Provider Identifier
1215304464
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02614700 Issued in NJ
Practice address
9-25 Alling St
Newark, NJ 07102
Phone
(973) 297-1550
NPI assigned
Aug 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02614700 NJ Primary

Addresses

Primary practice location

9-25 Alling St
Newark, NJ 07102

Mailing address

79 Washington PL
East Rutherford, NJ 07073-1343

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
I20151009001026 NJ Order and Referring Only - DentistPractitioner - Dentist 1254649312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02614700NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1215304464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WASHINGTON PL",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9-25 ALLING ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-297-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGIS",
        "first_name": "NANCY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02614700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.