Individual provider Active NPI

Gust G Kapetan, DMD

  • Dentist
  • West Palm Beach, FL
National Provider Identifier
1265634497
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17058 Issued in FL
Practice address
6076 Okeechobee Blvd
Suite 20
West Palm Beach, FL 33417-4351
Phone
(561) 687-1360
NPI assigned
Jun 1, 2007
Sex
Male
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
Dentist 122300000X 17058 FL Primary

Addresses

Primary practice location

6076 Okeechobee Blvd
Suite 20
West Palm Beach, FL 33417-4351

Mailing address

6076 Okeechobee Blvd
Suite 20
West Palm Beach, FL 33417-4351
Phone (561) 687-1360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20171102000040 FL Order and Referring Only - DentistPractitioner - Dentist 2961723200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17058FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Dentures - West Palm Beach, P.a. Dentist Past Accepting new patients
Affordable Dentures & Implants - West Palm Beach, P.a. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265634497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6076 OKEECHOBEE BLVD",
            "address_2": "SUITE 20",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174351",
            "telephone_number": "561-687-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6076 OKEECHOBEE BLVD",
            "address_2": "SUITE 20",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174351",
            "telephone_number": "561-687-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPETAN",
        "first_name": "GUST",
        "middle_name": "G",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "17058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.