Individual provider Active NPI

Gary Q Metzler, DDS

  • General Practice Dentistry
  • Mishawaka, IN
National Provider Identifier
1174568745
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008118 Issued in IN
Practice address
318 E 3Rd St
Mishawaka, IN 46544-2026
Phone
(574) 255-4964
NPI assigned
Jun 18, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 12008118 IN Primary

Addresses

Primary practice location

318 E 3Rd St
Mishawaka, IN 46544-2026

Mailing address

318 E 3Rd St
Mishawaka, IN 46544-2026
Phone (574) 255-4964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20161026001444 IN Order and Referring Only - DentistPractitioner - Dentist 7719265727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008118INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174568745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 E 3RD ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442026",
            "telephone_number": "574-255-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 E 3RD ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442026",
            "telephone_number": "574-255-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZLER",
        "first_name": "GARY",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.