Gregory Carl Perez, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DI16973 Issued in NJ

Practice address

230 Centre St
Nutley, NJ 07110-2877

Phone

(973) 667-1095

Fax

(973) 667-9611

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295881654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CENTRE ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102877",
            "telephone_number": "973-667-1095",
            "fax_number": "973-667-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 CENTRE ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102877",
            "telephone_number": "973-667-1095",
            "fax_number": "973-667-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "GREGORY",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI16973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Christina Peeters
• Cleotilde C. Pelgone, PHYSICAL THERAPIST
• Nicholas Gerard Pellicoro, DPM
• Jessica Peralta, M.S. CCC-SLP
• Kenia Peralta, CCC-SLP
• Jennifer Perez, LPC
• Periollp
• Pet/CT Center of New Jersey
• Kathleen Pete, LPC
• Caitlin Peterson, MSW

• Dentist in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Dentist in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.