Active NPI
Gezi Mebratu, DDS, PA
- Dentist
- Rockwall, TX
National Provider Identifier
1710001177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 21669
- Practice address
- 2918 Ridge Rd
Rockwall, TX 75032 - Phone
- (469) 769-1050
- Fax
- (469) 769-1202
- NPI assigned
- Mar 19, 2007
- Last updated
- Oct 17, 2024
- 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 | 21669 | TX | Primary |
Addresses
Primary practice location
2918 Ridge Rd
Rockwall, TX 75032
Mailing address
2918 Ridge Rd
Rockwall, TX 75032
Phone (469) 769-1050
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21669 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729123200000",
"number": "1710001177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2918 RIDGE RD",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "75032",
"telephone_number": "469-769-1050",
"fax_number": "469-769-1202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2918 RIDGE RD",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "75032",
"telephone_number": "469-769-1050",
"fax_number": "469-769-1202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEBRATU",
"first_name": "GEZI",
"name_prefix": "Dr.",
"credential": "DDS, PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2024-10-17",
"certification_date": "2024-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "21669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
- Madison Taylor McRae
- Molly Kathleen McStravick, M.D.
- Pamela A. McWhirter, LPC
- Stanley O. McWhirter, LPC
- Jeanna Lynn Mead, LMT
- Brandon Mecham, D.P.M.
- Medhill Home Health
- Medic Rescue Inc (Rockwall County EMS)
- Medical Edge Healthcare Group PA (Benchmark Family Medicine of Rockwall)
- Medical Edge Healthcare Group PA (Timothy Bray DO)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.