Provider Demographics
NPI:1215069901
Name:ABATE, GREGORY R (DDS)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:R
Last Name:ABATE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 FOREST AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128
Mailing Address - Country:US
Mailing Address - Phone:408-292-1654
Mailing Address - Fax:408-292-7913
Practice Address - Street 1:2075 FOREST AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128
Practice Address - Country:US
Practice Address - Phone:408-292-1654
Practice Address - Fax:408-292-7913
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA337161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice