MEDICARE: DR. GABRIEL PEREZ DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	22DI03085600	NJ

General Provider Information

NPI Number	:	1659069375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL PEREZ DMD

Provider Business Mailing Address
First Line	:	313 BUENA VISTA AVE
Second Line	:
City	:	LANDISVILLE
State	:	NJ
Zip	:	08326-1435
Country	:	US
Telephone Number	:	856-558-2848
Fax Number	:

Provider Business Practice Location Address
First Line	:	776 GROVE RD
Second Line	:
City	:	WEST DEPTFORD
State	:	NJ
Zip	:	08086-2234
Country	:	US
Telephone Number	:	856-848-2211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	07/22/2025

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