Individual provider Active NPI

Joseph M Gruberg, DMD

  • Dentist
  • Springfield, VA
National Provider Identifier
1326129305
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401005499 Issued in VA
Practice address
7485 Huntsman Blvd
Huntsman Boulevard
Springfield, VA 22153-1648
Phone
(703) 569-4422
Fax
(703) 569-0882
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401005499 VA Primary

Addresses

Primary practice location

7485 Huntsman Blvd
Huntsman Boulevard
Springfield, VA 22153-1648

Mailing address

7485 Huntsman Blvd
Springfield, VA 22153-1648
Phone (703) 569-4422

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

LicenseStateTypeSpecialty
0401005499VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326129305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7485 HUNTSMAN BLVD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221531648",
            "telephone_number": "703-569-4422",
            "fax_number": "703-569-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7485 HUNTSMAN BLVD",
            "address_2": "HUNTSMAN BOULEVARD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221531648",
            "telephone_number": "703-569-4422",
            "fax_number": "703-569-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBERG",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401005499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.