Individual provider Active NPI

Gary Mark Nataupsky, DMD

  • Dentist
  • Kingston, PA
National Provider Identifier
1457542409
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
021365L Issued in PA
Practice address
575 Pierce Street
Suite 201
Kingston, PA 18704-5700
Phone
(570) 331-8100
Fax
(570) 714-8100
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 021365L PA Primary

Addresses

Primary practice location

575 Pierce Street
Suite 201
Kingston, PA 18704-5700

Mailing address

575 Pierce Street
Suite 201
Kingston, PA 18704-5700
Phone (570) 331-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Feb 9, 2016 through Feb 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
021365LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1457542409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PIERCE STREET",
            "address_2": "SUITE 201",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045700",
            "telephone_number": "570-331-8100",
            "fax_number": "570-714-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PIERCE STREET",
            "address_2": "SUITE 201",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045700",
            "telephone_number": "570-331-8100",
            "fax_number": "570-714-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATAUPSKY",
        "first_name": "GARY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "021365L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.