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Deactivated NPI 1467651463 Deactivated / Inactive NPI Male Practitioner

Dr. Edward Dergosits , DDS

Dentist - General Practice • Mill Valley, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Edward Dergosits has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 11, 2007
NPI Deactivation Date October 26, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Edward Dergosits, DDS was a registered Dentist - General Practice practicing in Mill Valley, CA. Throughout an active medical career spanning 15 years, Dr. Dergosits provided care at the practice location at 295 MILLER AVE STE B until profile deactivation on 2022-10-26.

Practice Location & Contact Primary Location

Practice Address

295 Miller Ave Ste B

Mill Valley, CA 949412884

Telephone 4153836383
Fax 4153838647

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Mill Valley, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
20 Specialists

Practicing in Mill Valley, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 29580

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 26, 2022

Record deactivated on October 26, 2022

NPI Profile Active July 11, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 11, 2007

Registered at 295 MILLER AVE STE B, MILL VALLEY, CA 949412884 (Tel: 4153836383)

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Updated Business Mailing Address July 11, 2007

Registered at 295 MILLER AVE STE B, MILL VALLEY, CA 949412884 (Tel: 4153836383)

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Provider Name / Credentials Updated July 11, 2007

Recorded as EDWARD DERGOSITS, D.D.S

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 11, 2007

Dentist (License #29580 in CA)

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Initial NPI Registration & Enumeration July 11, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1467651463
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 11, 2007
Last Update: July 11, 2007
Deactivation Date: October 26, 2022

Mailing Address

295 Miller Ave Ste B

Mill Valley, CA 949412884

Phone: 4153836383

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.