Individual provider Active NPI

Gila Marciano, D.D.S.

  • General Practice Dentistry
  • Suffern, NY
National Provider Identifier
1376639773
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
P51291 Issued in NY
Practice address
12 N Airmont Rd Ste 4a
Suffern, NY 10901-5136
Phone
(845) 357-0970
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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 P51291 NY Primary

Addresses

Primary practice location

12 N Airmont Rd Ste 4a
Suffern, NY 10901-5136

Mailing address

15 Marshall Dr
Edison, NJ 08817-2910
Phone (845) 641-8987

Other practice location 1

11 lyncrest drive
monsey, NY 10952
Phone (201) 408-4078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151007000021 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0941518237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P51291NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
SFS Dental PC General Practice Current Accepting new patients
Denville Dentistry by Design LLC General Practice CurrentSince Oct 29, 2023 Accepting new patients
Dentistry by Design DDS Current Accepting new patients

Organizations & group practices 3

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1376639773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MARSHALL DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172910",
            "telephone_number": "845-641-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N AIRMONT RD STE 4A",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015136",
            "telephone_number": "845-357-0970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 lyncrest drive",
            "address_purpose": "LOCATION",
            "city": "monsey",
            "state": "NY",
            "postal_code": "10952",
            "country_code": "US",
            "telephone_number": "201-408-4078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCIANO",
        "first_name": "GILA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "P51291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.