Individual provider Active NPI

Ross Michael Gille, DDS

  • General Practice Dentistry
  • Fairfield, OH
National Provider Identifier
1053577528
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-022785 Issued in OH
Practice address
571 Wessel Dr
Fairfield, OH 45014-3668
Phone
(513) 939-3200
Fax
(513) 939-1358
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-022785 OH Primary

Addresses

Primary practice location

571 Wessel Dr
Fairfield, OH 45014-3668

Mailing address

571 Wessel Dr
Fairfield, OH 45014-3668
Phone (513) 939-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150206000897 OH Order and Referring Only - DentistPractitioner - Dentist 6002131448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-022785OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1053577528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 WESSEL DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143668",
            "telephone_number": "513-939-3200",
            "fax_number": "513-939-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 WESSEL DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143668",
            "telephone_number": "513-939-3200",
            "fax_number": "513-939-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLE",
        "first_name": "ROSS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.