Individual provider Active NPI

Sally Ann Gerges, DMD

  • Dentist
  • Middletown, NJ
National Provider Identifier
1376777912
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
02440700 Issued in NJ
Practice address
9 Leonardville Rd
Middletown, NJ 07748-2360
Phone
(732) 671-3699
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 02440700 NJ Primary

Addresses

Primary practice location

9 Leonardville Rd
Middletown, NJ 07748-2360

Mailing address

9 Leonardville Rd
Middletown, NJ 07748-2360
Phone (732) 671-3699

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150609001396 NJ Order and Referring Only - DentistPractitioner - Dentist 0042531592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02440700NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1376777912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 LEONARDVILLE RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482360",
            "telephone_number": "732-671-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 LEONARDVILLE RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482360",
            "telephone_number": "732-671-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGES",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "02440700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NJ

Sources for this page

Verify at the official NPI Registry.