Individual provider Active NPI

Maria Gesiotto Mackarey, D.D.S.

  • General Practice Dentistry
  • Scranton, PA
National Provider Identifier
1255539045
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS 027 288L Issued in PA
Practice address
632 Davis St
Scranton, PA 18505-4666
Phone
(570) 969-1838
Fax
(570) 963-5790
NPI assigned
Jul 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 DS 027 288L PA Primary

Addresses

Primary practice location

632 Davis St
Scranton, PA 18505-4666

Mailing address

535 Simerell Rd
Clarks Summit, PA 18411-8849
Phone (570) 586-4594

Other identifiers 1

IdentifierTypeStateIssuer
01411350MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS 027 288LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255539045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 SIMERELL RD",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184118849",
            "telephone_number": "570-586-4594",
            "fax_number": "570-586-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 DAVIS ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185054666",
            "telephone_number": "570-969-1838",
            "fax_number": "570-963-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAREY",
        "first_name": "MARIA",
        "middle_name": "GESIOTTO",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS 027 288L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01411350",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.