Active NPI
Gary R Kushner, DDS
- Public Health Dentistry
- Charlotte, NC
National Provider Identifier
1144240854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- NC 4858
- Practice address
- 1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228 - Phone
- (704) 350-7300
- Fax
- (704) 350-7304
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | NC 4858 | NC | Primary |
Addresses
Primary practice location
1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Mailing address
1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone (704) 350-7300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015N0 | Other | NC | NC HEALTH CHOICE |
| 89902YU | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC 4858 | NC | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1144240854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 ROZZELLES FERRY RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282084228",
"telephone_number": "704-350-7300",
"fax_number": "704-350-7304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 ROZZELLES FERRY RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282084228",
"telephone_number": "704-350-7300",
"fax_number": "704-350-7304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSHNER",
"first_name": "GARY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "NC",
"license": "NC 4858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC HEALTH CHOICE",
"identifier": "015N0",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89902YU",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.