Active NPI
Paul B Gabriel, DMD
- General Practice Dentistry
- Wexford, PA
National Provider Identifier
1346335411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS 029315L
- Practice address
- 2500 Brooktree Rd
Suite 100
Wexford, PA 15090-9278 - Phone
- (724) 935-2100
- Fax
- (724) 935-2133
- NPI assigned
- Oct 4, 2006
- Last updated
- Jun 8, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS 029315L | PA | Primary |
Addresses
Primary practice location
2500 Brooktree Rd
Suite 100
Wexford, PA 15090-9278
Mailing address
2500 Brooktree Rd
Suite 100
Wexford, PA 15090-9278
Phone (724) 935-2100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 790410 | Other | PA | UNITED CONCORDIA PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231219001031 | PA | Order and Referring Only - Dentist | 4385958776 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS 029315L | PA | MD | General Practice Dentistry |
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.
-
- Dentist
- Wexford, PA
- NPI 1114199114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307491200000",
"number": "1346335411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 BROOKTREE RD",
"address_2": "SUITE 100",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150909278",
"telephone_number": "724-935-2100",
"fax_number": "724-935-2133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 BROOKTREE RD",
"address_2": "SUITE 100",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150909278",
"telephone_number": "724-935-2100",
"fax_number": "724-935-2133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GABRIEL",
"first_name": "PAUL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2011-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS 029315L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA PROVIDER",
"identifier": "790410",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.