Individual provider Active NPI

Gary John Mosso, D.M.D.

  • General Practice Dentistry
  • Wexford, PA
National Provider Identifier
1568678589
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS022371L Issued in PA
Practice address
10441 Perry Hwy
Suite 4
Wexford, PA 15090-9292
Phone
(724) 935-9720
Fax
(724) 935-9724
NPI assigned
May 15, 2007
Last updated
Aug 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS022371L PA Primary

Addresses

Primary practice location

10441 Perry Hwy
Suite 4
Wexford, PA 15090-9292

Mailing address

10441 Perry Highway
Suite 4
Wexford, PA 15095-9292
Phone (724) 935-9720

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
DS022371LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1568678589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10441 PERRY HIGHWAY",
            "address_2": "SUITE 4",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150959292",
            "telephone_number": "724-935-9720",
            "fax_number": "724-935-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10441 PERRY HWY",
            "address_2": "SUITE 4",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909292",
            "telephone_number": "724-935-9720",
            "fax_number": "724-935-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSO",
        "first_name": "GARY",
        "middle_name": "JOHN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS022371L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.