Individual provider Active NPI

Pasquale Dellagatta

  • General Practice Dentistry
  • Mayfield HTS, OH
National Provider Identifier
1780755462
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.020279 Issued in OH
Practice address
5875 Landerbrook Dr Ste 250
Mayfield HTS, OH 44124-6502
Phone
(800) 487-4867
Fax
(216) 593-7533
NPI assigned
Nov 13, 2006
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.020279 OH Primary

Addresses

Primary practice location

5875 Landerbrook Dr Ste 250
Mayfield HTS, OH 44124-6502

Mailing address

5875 Landerbrook Dr Ste 250
Mayfield HTS, OH 44124-6502
Phone (800) 487-4867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160815001645 TX Order and Referring Only - DentistPractitioner - Dentist 9931410925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Dellagatta Dental General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1780755462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 LANDERBROOK DR STE 250",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441246502",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 LANDERBROOK DR STE 250",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441246502",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLAGATTA",
        "first_name": "PASQUALE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.020279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

Verify at the official NPI Registry.