Steven Wayne Gajda, DDS, MSD

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Madison, OH

NPI 1245496264 · NPPES record last updated Jun 25, 2015

Key facts

NPI
1245496264
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
30022716 (OH)
Practice address
2040 Hubbard Rd
Madison, OH 44057-2566
Phone
(440) 428-7290
Fax
(440) 428-0911
NPI assigned
Jul 29, 2008
Sex
Male
Sole proprietor
No

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
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160705002071 OH Order and Referring Only - Dentist
Practitioner - Dentist
7517259922

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
30022716OHMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Dental Specialists, Dr. Steven W Gajda Past Accepting new patients

Specialties & licenses

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

Addresses

Primary practice location

2040 Hubbard Rd
Madison, OH 44057-2566

Mailing address

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

Other providers in Madison, OH

All providers in Madison, OH · Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

Sources for this page

Verify at the official NPI Registry.