Healthcare Provider Details

I. General information

NPI: 1518033570
Provider Name (Legal Business Name): GERALD A FERRETTI DDS, MS,MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE SUITE 1200 MS 6018
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

12614 MAYFIELD RD
CLEVELAND HTS OH
44106-6200
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3080
  • Fax: 216-844-3086
Mailing address:
  • Phone: 216-246-4990
  • Fax: 216-844-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number16936
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: