Individual provider Active NPI

Christopher W. Gall, D.D.S.

  • General Practice Dentistry
  • Griffith, IN
National Provider Identifier
1376637298
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009469A Issued in IN
Practice address
909 E Glen Park Ave
Griffith, IN 46319-2434
Phone
(219) 838-5111
Fax
(219) 923-3059
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
General Practice Dentistry 1223G0001X 12009469A IN Primary

Addresses

Primary practice location

909 E Glen Park Ave
Griffith, IN 46319-2434

Mailing address

909 E Glen Park Ave
Griffith, IN 46319-2434
Phone (219) 838-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150317000376 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335466101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009469AINMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376637298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E GLEN PARK AVE",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463192434",
            "telephone_number": "219-838-5111",
            "fax_number": "219-923-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E GLEN PARK AVE",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463192434",
            "telephone_number": "219-838-5111",
            "fax_number": "219-923-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALL",
        "first_name": "CHRISTOPHER",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009469A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffith, IN

Sources for this page

Verify at the official NPI Registry.