Active NPI
David J Gaz, D.M.D.
- Dentist
- Newark, DE
National Provider Identifier
1699836742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- G10001208
- Practice address
- 715 Nottingham Road
Newark, DE 19711 - Phone
- (302) 525-6463
- Fax
- (302) 525-6456
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | G10001208 | DE | Primary |
Addresses
Primary practice location
715 Nottingham Road
Newark, DE 19711
Mailing address
715 Nottingham Road
Newark, DE 19711
Phone (302) 525-6463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000039458 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151123000051 | DE | Order and Referring Only - Dentist | 6800196924 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G10001208 | DE | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Small Wonder Family Dental | 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.
-
- General Practice Dentistry
- Newark, DE
- NPI 1386897973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377561600000",
"number": "1699836742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 NOTTINGHAM ROAD",
"city": "NEWARK",
"state": "DE",
"postal_code": "19711",
"telephone_number": "302-525-6463",
"fax_number": "302-525-6456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 NOTTINGHAM ROAD",
"city": "NEWARK",
"state": "DE",
"postal_code": "19711",
"telephone_number": "302-525-6463",
"fax_number": "302-525-6456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAZ",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2013-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DE",
"license": "G10001208",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000039458",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.