Individual provider Active NPI

David J Gaz, D.M.D.

  • Dentist
  • Newark, DE
National Provider Identifier
1699836742
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G10001208 Issued in DE
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

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1000039458MedicaidDE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123000051 DE Order and Referring Only - DentistPractitioner - Dentist 6800196924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G10001208DEMDDentist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.