Fred C Gaeta, MA DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1156 Issued in HI

Practice address

75-5706 Hanama PL
Suite 105a
Kailua Kona, HI 96740-1745

Phone

(808) 329-3314

Fax

(808) 329-1354

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Fredric C Gaeta DDS

  • General Practice Dentistry
  • Kailua Kona, HI
  • NPI 1043606270
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386745735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5706 HANAMA PL",
            "address_2": "SUITE 105A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401745",
            "telephone_number": "808-329-3314",
            "fax_number": "808-329-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5706 HANAMA PL",
            "address_2": "SUITE 105A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401745",
            "telephone_number": "808-329-3314",
            "fax_number": "808-329-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETA",
        "first_name": "FRED",
        "middle_name": "C",
        "credential": "MA DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "1156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HDS",
            "identifier": "1938",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "J29007",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Fuller, L.M.T
• Shane R Fullerton
• Ellie Barbara Furneisen
• Izumi Furukawa, AU.D
• Gabrielle Parilla Rd, LLC
• Eyita Gaga, RN, CNM
• Seth Gambee, D.C.
• Grethen Gamet, APRN, AGNP-C
• Carolyn Kay Gandalira
• Kelsey Gann, PT, DPT

• General Practice Dentistry in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• General Practice Dentistry in Hawaii

• 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.