Edward Roy Gillis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4317 Issued in MD

Practice address

10203 Tanager LN
Columbia, MD 21044-3904

Phone

(410) 730-3800

Fax

(410) 730-9665

NPI assigned

Jun 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1164427688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 SNOWDEN RIVER PKWY",
            "address_2": "STE 106",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451982",
            "telephone_number": "410-730-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10203 TANAGER LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443904",
            "telephone_number": "410-730-3800",
            "fax_number": "410-730-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "EDWARD",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "4317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adele Morales Gill, LAC
• Katherine Corinne Gill
• Madison Gillen, PT, DPT
• Pierre Gilles
• Aurora Gillespie
• Julia Francis Gilloran
• Holly Pittman Gillum, LCSW-C
• Gabriella D Gilpin, NONE
• Sarah Gingerelli
• Dennis S. Ginsberg, M.D.

• General Practice Dentistry in Columbia, MD
• Providers in Columbia, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.