Individual provider Active NPI

Gerard A. Moretti, DMD, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Worth, FL
National Provider Identifier
1548377237
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6230 Issued in FL
Practice address
4765 S. Congress Ave
Suite 1
Lake Worth, FL 33461-4701
Phone
(561) 439-6600
Fax
(561) 439-7660
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6230 FL Primary

Addresses

Primary practice location

4765 S. Congress Ave
Suite 1
Lake Worth, FL 33461-4701

Mailing address

4765 S. Congress Ave
Suite 1
Lake Worth, FL 33461-4701
Phone (561) 439-6600

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6230FLMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral & Facial Surgery Center Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1548377237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 S. CONGRESS AVE",
            "address_2": "SUITE 1",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614701",
            "telephone_number": "561-439-6600",
            "fax_number": "561-439-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 S. CONGRESS AVE",
            "address_2": "SUITE 1",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614701",
            "telephone_number": "561-439-6600",
            "fax_number": "561-439-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETTI",
        "first_name": "GERARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DMD, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "6230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.