Active NPI
Gregory Michael Gittleman, D.M.D.
- Dentist
- Portsmouth, VA
National Provider Identifier
1033497383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS038817
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-2708
- NPI assigned
- Aug 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS038817 | PA | |
| Dentist | 122300000X | DS038817 | PA | Primary |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
8901 Wisconsin Ave
Bethesda, MD 20889-0001
Phone (301) 295-0145
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210709000560 | PA | Order and Referring Only - Dentist | 2365844693 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS038817 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1033497383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8901 WISCONSIN AVE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208890001",
"telephone_number": "301-295-0145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-2708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GITTLEMAN",
"first_name": "GREGORY",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-03",
"last_updated": "2022-12-05",
"certification_date": "2022-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PA",
"license": "DS038817",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS038817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
- Uhurua Amber-Fawnn Gillespie, FNP-BC
- Deshawnda Dulani Gilliam, PHARMD
- Joshua Henry Gilliam, DNP, APRN
- Kristina Marie Ginorio, RDH
- Susan B. Girois, M.D., M.P.H.
- GL Virginia Portsmouth, LLC (Portsmouth Health and Rehab)
- Glascow Health Services LLC
- Haley Nicole Glaser, DO
- Lindsey Gleason
- Luis Alexander Glinton, IDC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.