Gabriel Proulx, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

057450 Issued in NY

Practice address

1 Murray Hill Dr
Building #1, Room 140
Mount Morris, NY 14510-1153

Phone

(585) 243-7840

NPI assigned

Jun 16, 2014

Last updated

Apr 21, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mosaic Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mount Morris, NY
  • NPI 1598073777

  General Practice

  NPD (past)

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1386058550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MURRAY HILL DR",
            "address_2": "BUILDING #1 ROOM 140",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145101153",
            "telephone_number": "585-243-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MURRAY HILL DR",
            "address_2": "BUILDING #1, ROOM 140",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145101153",
            "telephone_number": "585-243-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROULX",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039593",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Ann Paul
• Rebecca Paul, MS, CCC-SLP/L
• Peggy Hamilton
• Amy Peraino
• Laura Marie Piche, CCC-SLP
• Kristin Marie Provo, PT, DPT
• Tonia Lyn Prutsman, LPN
• Rite Aid of New York Inc (Rite Aid Pharmacy 01871)
• Sonya Marie Roberts, A.S.
• Janet D Robinson, MA CCC-SLP

• General Practice Dentistry in Mount Morris, NY
• Providers in Mount Morris, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.