Active NPI
Gary Adiska
- Dentist
- Stockbridge, MI
National Provider Identifier
1205249653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901014371
- Practice address
- 100 W Main St
Stockbridge, MI 49285-9483 - Phone
- (517) 851-8008
- Fax
- (517) 851-8836
- NPI assigned
- Jun 3, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2901014371 | MI | Primary |
Addresses
Primary practice location
100 W Main St
Stockbridge, MI 49285-9483
Mailing address
100 W Main St
PO Box 519
Stockbridge, MI 49285-9483
Phone (517) 851-8008
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 |
|---|---|---|---|
| 2901014371 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary Adiska D.D.S., P.C. | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Stockbridge, MI
- NPI 1538277215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401753600000",
"number": "1205249653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W MAIN ST",
"address_2": "PO BOX 519",
"city": "STOCKBRIDGE",
"state": "MI",
"postal_code": "492859483",
"telephone_number": "517-851-8008",
"fax_number": "517-851-8836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W MAIN ST",
"city": "STOCKBRIDGE",
"state": "MI",
"postal_code": "492859483",
"telephone_number": "517-851-8008",
"fax_number": "517-851-8836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADISKA",
"first_name": "GARY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-03",
"last_updated": "2014-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901014371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.