Individual provider Active NPI

Martina Waguih Naguib Gerges

  • Endodontics
  • Middleburg Heights, OH
National Provider Identifier
1912385501
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
30.025207 Issued in OH
Practice address
7081 Pearl Rd
Middleburg Heights, OH 44130-4940
Phone
(216) 282-1491
Fax
(216) 920-9592
NPI assigned
May 14, 2015
Last updated
Apr 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 30.025207 OH Primary

Addresses

Primary practice location

7081 Pearl Rd
Middleburg Heights, OH 44130-4940

Mailing address

7081 Pearl Rd
Middleburg Heights, OH 44130-4940
Phone (216) 282-1491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170913003119 OH Order and Referring Only - DentistPractitioner - Dentist 1759654726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.025207OHMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
DDC Endodontics LLC Endodontics PastSince Jun 22, 2021 Accepting new patients
Cresta Dental Implants LLC Endodontics PastSince Jun 22, 2021 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, 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": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1912385501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7081 PEARL RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441304940",
            "telephone_number": "216-282-1491",
            "fax_number": "216-920-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7081 PEARL RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441304940",
            "telephone_number": "216-282-1491",
            "fax_number": "216-920-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGES",
        "first_name": "MARTINA",
        "middle_name": "WAGUIH NAGUIB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.025207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.