Individual provider Active NPI

John I Gray III, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mt Sterling, KY
National Provider Identifier
1043396963
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4210 Issued in KY
Practice address
25 E High St
Mt Sterling, KY 40353-1267
Phone
(859) 498-6204
Fax
(859) 498-6205
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 306 KY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4210 KY Primary

Addresses

Primary practice location

25 E High St
Mt Sterling, KY 40353-1267

Mailing address

25 E High St
Mt Sterling, KY 40353-1267
Phone (859) 498-6204

Other practice location 1

2195 Harrodsburg Rd
Ste 175
Lexington, KY 40504-3504
Phone (859) 323-8873

Other identifiers 1

IdentifierTypeStateIssuer
64942584MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051027000979 KY Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 2567361868 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4210KYMDChiropractor
306KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery & Implant Associates Oral and Maxillofacial Surgery CurrentSince Sep 7, 2022 Accepting new patients
Oral Surgery & Implant Associates Oral and Maxillofacial Surgery CurrentSince Sep 7, 2022 Accepting new patients
University of Kentucky CurrentSince Jul 24, 2019 Accepting new patients
University of Kentucky CurrentSince Jul 24, 2019 Accepting new patients

Locations

770 Rose St
Lexington, KY 40536
Phone (859) 323-3368

25 E High St
Mt Sterling, KY 40353
Phone (859) 498-1215

25 E High St
Ste 1
Mt Sterling, KY 40353
Phone (859) 498-6204

1303 W Lexington Ave
Winchester, KY 40391
Phone (606) 744-0677

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1043396963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E HIGH ST",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531267",
            "telephone_number": "859-498-6204",
            "fax_number": "859-498-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E HIGH ST",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531267",
            "telephone_number": "859-498-6204",
            "fax_number": "859-498-6205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2195 Harrodsburg Rd",
            "address_2": "Ste 175",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043504",
            "country_code": "US",
            "telephone_number": "859-323-8873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JOHN",
        "middle_name": "I",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "306",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "4210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64942584",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

Verify at the official NPI Registry.