Individual provider Active NPI

Marcus Ryan Gillon, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • High Point, NC
National Provider Identifier
1033603030
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11321 Issued in NC
Practice address
901 N Lindsay St
High Point, NC 27262-3903
Phone
(336) 884-8771
Fax
(336) 884-8770
NPI assigned
Jun 22, 2018
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 11321 NC Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 018.002071 NC

Addresses

Primary practice location

901 N Lindsay St
High Point, NC 27262-3903

Mailing address

901 N Lindsay St
High Point, NC 27262-3903
Phone (336) 884-8771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
University of Texas Medical School at Houston, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

233 Joe Hege Rd
Clemmons, NC 27012-7334

3200 Bellefontaine St Apt
Suite 65
Houston, TX 77025-1412

502 Perry Rd
Troutman, NC 28166-9581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018.002071NCMDOral & Maxillofacial Surgery (D.M.D.)
11321NCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Desalvo and Newsome LLP Oral and Maxillofacial Surgery CurrentSince Jul 30, 2025 Accepting new patients

Locations

901 N Lindsay St
High Point, NC 27262
Phone (336) 884-8771

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1033603030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N LINDSAY ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623903",
            "telephone_number": "336-884-8771",
            "fax_number": "336-884-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N LINDSAY ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623903",
            "telephone_number": "336-884-8771",
            "fax_number": "336-884-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLON",
        "first_name": "MARCUS",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "11321",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "018.002071",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.