Individual provider Active NPI

Carmen A Gatta, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Suffern, NY
National Provider Identifier
1730230269
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
36540 Issued in NY
Practice address
79 Route 59
Suite 1
Suffern, NY 10901-4913
Phone
(845) 368-1677
Fax
(845) 368-8655
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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 36540 NY Primary

Addresses

Primary practice location

79 Route 59
Suite 1
Suffern, NY 10901-4913

Mailing address

79 Route 59
Suite 1
Suffern, NY 10901-4913
Phone (845) 368-1677

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
36540NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1730230269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 ROUTE 59",
            "address_2": "SUITE 1",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014913",
            "telephone_number": "845-368-1677",
            "fax_number": "845-368-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 ROUTE 59",
            "address_2": "SUITE 1",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014913",
            "telephone_number": "845-368-1677",
            "fax_number": "845-368-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATTA",
        "first_name": "CARMEN",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "36540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.