Provider Demographics
NPI:1518033570
Name:FERRETTI, GERALD A (DDS, MS,MPH)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:A
Last Name:FERRETTI
Suffix:
Gender:M
Credentials:DDS, MS,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12614 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-6200
Mailing Address - Country:US
Mailing Address - Phone:216-246-4990
Mailing Address - Fax:216-844-3086
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:SUITE 1200 MS 6018
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3080
Practice Address - Fax:216-844-3086
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH169361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0635236Medicaid