Gary Eugene Epp, DDS
Individual provider Active NPI Dentist · Eveleth, MN
NPI 1174866255 · NPPES record last updated Mar 27, 2013
Key facts
- NPI
- 1174866255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 7799 (MN)
- Practice address
- 320 Grant Ave
Eveleth, MN 55734-1524 - Phone
- (218) 744-5440
- Fax
- (218) 744-5441
- NPI assigned
- Mar 27, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170621000010 | MN | Order and Referring Only - Dentist |
5193093912 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7799 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eveleth Dental Associates | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7799 | MN | Yes |
Addresses
Primary practice location
320 Grant Ave
Eveleth, MN 55734-1524
Mailing address
320 Grant Ave
Eveleth, MN 55734-1524
Phone (218) 744-5440
Other providers in Eveleth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.