Chris V Geroff, DDS

Individual provider Active NPI General Practice Dentistry · Gainesville, MO

NPI 1184839391 · NPPES record last updated Apr 20, 2017

Key facts

NPI
1184839391
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DE010823 (MO)
Practice address
195 Main Street
Gainesville, MO 65655
Phone
(417) 679-3509
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DE010823MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chris V Geroff DDS PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE010823 MO Yes

Addresses

Primary practice location

195 Main Street
Gainesville, MO 65655

Mailing address

PO Box 660
195 Main St
Gainesville, MO 65655-0660
Phone (417) 679-3509

Other identifiers

IdentifierTypeStateIssuer
DE010823OtherMOMO LICENSE NUMBER

Other providers in Gainesville, MO

All providers in Gainesville, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.