Individual provider Active NPI

Steven Wayne Gajda, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Madison, OH
National Provider Identifier
1245496264
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
30022716 Issued in OH
Practice address
2040 Hubbard Rd
Madison, OH 44057-2566
Phone
(440) 428-7290
Fax
(440) 428-0911
NPI assigned
Jul 29, 2008
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 30022716 OH Primary

Addresses

Primary practice location

2040 Hubbard Rd
Madison, OH 44057-2566

Mailing address

2040 Hubbard Rd
Madison, OH 44057-2566
Phone (440) 428-7290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160705002071 OH Order and Referring Only - DentistPractitioner - Dentist 7517259922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30022716OHMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Dental Specialists, Dr. Steven W Gajda 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1245496264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 HUBBARD RD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572566",
            "telephone_number": "440-428-7290",
            "fax_number": "440-428-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 HUBBARD RD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572566",
            "telephone_number": "440-428-7290",
            "fax_number": "440-428-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJDA",
        "first_name": "STEVEN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30022716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, OH

Sources for this page

Verify at the official NPI Registry.