Individual provider Active NPI

Lewis D. Gilbert, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Summersville, WV
National Provider Identifier
1376568634
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
068 Issued in WV
Practice address
807 Broad St
Summersville, WV 26651-1706
Phone
(304) 872-0300
Fax
(304) 872-5999
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2262 WV
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 068 WV Primary

Addresses

Primary practice location

807 Broad St
Summersville, WV 26651-1706

Mailing address

PO Box 1008
Summersville, WV 26651-0048
Phone (304) 872-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 27, 2020 through Oct 27, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068WVMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Brock, Henderson, Di Prisco, Ravelo and Green Inc Oral and Maxillofacial Surgery CurrentSince Jan 12, 2020 Accepting new patients

Locations

433 Carriage Dr
Beckley, WV 25801
Phone (304) 256-3777

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1376568634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1008",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266510048",
            "telephone_number": "304-872-0300",
            "fax_number": "304-872-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 BROAD ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511706",
            "telephone_number": "304-872-0300",
            "fax_number": "304-872-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "LEWIS",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "2262",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

Verify at the official NPI Registry.