Individual provider Active NPI

Gerald J. Pieroni, DDS

  • Periodontics
  • Fresno, CA
National Provider Identifier
1790966455
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
25188 Issued in CA
Practice address
7760 N Fresno St Ste 105
Fresno, CA 93720-2411
Phone
(559) 432-1400
Fax
(559) 432-6955
NPI assigned
Nov 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 25188 CA Primary

Addresses

Primary practice location

7760 N Fresno St Ste 105
Fresno, CA 93720-2411

Mailing address

7760 N Fresno St Ste 105
Fresno, CA 93720-2411
Phone (559) 432-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 30, 2016 through Mar 30, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25188CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1790966455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7760 N FRESNO ST STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202411",
            "telephone_number": "559-432-1400",
            "fax_number": "559-432-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7760 N FRESNO ST STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202411",
            "telephone_number": "559-432-1400",
            "fax_number": "559-432-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERONI",
        "first_name": "GERALD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "25188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.