NPIMap

Individual provider Active NPI

Mark A Delli-Gatti, DDS

  • Dentist
  • Parkersburg, WV
National Provider Identifier
1770503443
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2447 Issued in WV
Practice address
2905 Dudley Ave
Parkersburg, WV 26101-2107
Phone
(304) 424-5002
Fax
(304) 422-5740
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2447 WV Primary

Addresses

Primary practice location

2905 Dudley Ave
Parkersburg, WV 26101-2107

Mailing address

2905 Dudley Ave
Parkersburg, WV 26101-2107
Phone (304) 424-5002

Other identifiers 1

IdentifierTypeStateIssuer
0136695000MedicaidWV

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
2447WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark a. Delli-Gatti, D.D.S. & Associates Past Accepting new patients
Erica Bailey, DDS and Chad Bush, DDS, PLLC Past Accepting new patients

Organizations & group practices 2

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770503443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 DUDLEY AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261012107",
            "telephone_number": "304-424-5002",
            "fax_number": "304-422-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 DUDLEY AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261012107",
            "telephone_number": "304-424-5002",
            "fax_number": "304-422-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLI-GATTI",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "2447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136695000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.