Individual provider Active NPI

Christopher Matthew Gerwig, D.D.S.

  • General Practice Dentistry
  • Lubbock, TX
National Provider Identifier
1376647008
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22680 Issued in TX
Practice address
4425 98TH St
Suite 100
Lubbock, TX 79424-5029
Phone
(806) 794-7479
NPI assigned
Sep 12, 2006
Last updated
Jun 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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 22680 TX Primary

Addresses

Primary practice location

4425 98TH St
Suite 100
Lubbock, TX 79424-5029

Mailing address

4805 99TH St
Lubbock, TX 79424-6357
Phone (806) 786-5844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150608002024 TX Order and Referring Only - DentistPractitioner - Dentist 6305167982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22680TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gerwig Family Dental PLLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1376647008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 99TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246357",
            "telephone_number": "806-786-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 98TH ST",
            "address_2": "SUITE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245029",
            "telephone_number": "806-794-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERWIG",
        "first_name": "CHRISTOPHER",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.