Individual provider Active NPI

Paul B Gabriel, DMD

  • General Practice Dentistry
  • Wexford, PA
National Provider Identifier
1346335411
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS 029315L Issued in PA
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, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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 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

IdentifierTypeStateIssuer
790410OtherPAUNITED 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219001031 PA Order and Referring Only - DentistPractitioner - Dentist 4385958776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS 029315LPAMDGeneral 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.

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

Verify at the official NPI Registry.