Active NPI
Elliott Jonathan Gray, DDS
- Dentist
- Salisbury, MD
National Provider Identifier
1306910146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4993
- Practice address
- 1346 S Division St
Suite 104
Salisbury, MD 21804 - Phone
- (410) 749-0108
- Fax
- (410) 749-8392
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 4993 | MD | Primary |
Addresses
Primary practice location
1346 S Division St
Suite 104
Salisbury, MD 21804
Mailing address
30103 South Hampton Bridge Rd
Sailsbury, MD 21804
Phone (410) 749-6157
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 12, 2016 through Jan 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4993 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gray White & Allen DDS PA | Dentist | 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.
-
- Dentist
- Salisbury, MD
- NPI 1376617126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306910146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30103 SOUTH HAMPTON BRIDGE RD",
"city": "SAILSBURY",
"state": "MD",
"postal_code": "21804",
"telephone_number": "410-749-6157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1346 S DIVISION ST",
"address_2": "SUITE 104",
"city": "SALISBURY",
"state": "MD",
"postal_code": "21804",
"telephone_number": "410-749-0108",
"fax_number": "410-749-8392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "ELLIOTT",
"middle_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "4993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.