Gino Anthony Gismondi, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3781 Issued in WV

Practice address

700 W Pike St
Suite 100
Clarksburg, WV 26301-2696

Phone

(304) 622-4828

Fax

(304) 624-0977

NPI assigned

Jul 19, 2007

Last updated

Feb 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1225238041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W PIKE ST",
            "address_2": "SUITE 100",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012696",
            "telephone_number": "304-622-4828",
            "fax_number": "304-624-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W PIKE ST",
            "address_2": "SUITE 100",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012696",
            "telephone_number": "304-622-4828",
            "fax_number": "304-624-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISMONDI",
        "first_name": "GINO",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "WV3781",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "3781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810026369",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORIDA",
            "identifier": "002997279",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ghassan Richard Ghorayeb, MD
• Jeffrey Gill, PHARMD
• Alecia Gillespie
• Leeann N Gillespie
• Gino a Gismondi DDS PLLC
• Robert G Given Jr., PAC
• Susan Lewis Given, MPAS, PAC
• Megan Glass
• Karen A Glogowski, M.D.
• Christa Noel Glover

• Oral and Maxillofacial Surgery (Dentist) in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Oral and Maxillofacial Surgery (Dentist) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.