Individual provider Active NPI

John Gentile, D.M.D.

  • General Practice Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1114155009
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
TP-0141 Issued in IA
Practice address
4250 Glass Rd NE
Cedar Rapids, IA 52402-2503
Phone
(319) 395-7207
NPI assigned
Jun 30, 2009
Last updated
Sep 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL10632 MA
General Practice Dentistry 1223G0001X TP-0141 IA Primary

Addresses

Primary practice location

4250 Glass Rd NE
Cedar Rapids, IA 52402-2503

Mailing address

409 Trafton Rd
Springfield, MA 01108-2647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20171109000855 MA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6204116304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DL10632MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Value Dental Centers of Massachusetts, PLLC. General Practice Past Accepting new patients
New England Family Dentistry ,PC Past Accepting new patients
Lynn Smiles Youth Dentistry, LLC General Practice Past Accepting new patients

Organizations & group practices 3

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1114155009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 TRAFTON RD",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011082647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 GLASS RD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022503",
            "telephone_number": "319-395-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "JOHN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL10632",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "TP-0141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.