Individual provider Active NPI

Christine George Gabra, DMD

  • Dentist
  • Stoneham, MA
National Provider Identifier
1407556137
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1859972 Issued in MA
Practice address
67 Montvale Ave Ste 101
Stoneham, MA 02180-3618
Phone
(781) 279-2400
Fax
(781) 279-4640
NPI assigned
Mar 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1859972 MA Primary

Addresses

Primary practice location

67 Montvale Ave Ste 101
Stoneham, MA 02180-3618

Mailing address

11 Celestine Ter
Stoneham, MA 02180-3320
Phone (929) 215-4224

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
DN1859972MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stoneham Pediatric Dental Associates, PC Dentist PastSince Sep 24, 2023 Accepting new patients
Eugene a Mickey, DMD, MPH, PC PastSince Sep 24, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1407556137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CELESTINE TER",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803320",
            "telephone_number": "929-215-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 MONTVALE AVE STE 101",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803618",
            "telephone_number": "781-279-2400",
            "fax_number": "781-279-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRA",
        "first_name": "CHRISTINE",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.