Individual provider Active NPI

John J. Gaeta, D.D.S.

  • General Practice Dentistry
  • Glen Cove, NY
National Provider Identifier
1356562391
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34387 Issued in NY
Practice address
One School Street
Suite #105
Glen Cove, NY 11542
Phone
(516) 671-0817
Fax
(516) 671-3441
NPI assigned
May 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
General Practice Dentistry 1223G0001X 34387 NY Primary

Addresses

Primary practice location

One School Street
Suite #105
Glen Cove, NY 11542

Mailing address

One School Street
Suite #105
Glen Cove, NY 11542
Phone (516) 671-0817

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
34387NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356562391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE SCHOOL STREET",
            "address_2": "SUITE #105",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "11542",
            "telephone_number": "516-671-0817",
            "fax_number": "516-671-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE SCHOOL STREET",
            "address_2": "SUITE #105",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "11542",
            "telephone_number": "516-671-0817",
            "fax_number": "516-671-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETA",
        "first_name": "JOHN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "34387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

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.