Individual provider Active NPI

Gregory C Michaels, D.D.S., M.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Lancaster, OH
National Provider Identifier
1396884805
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
30019438 Issued in OH
Practice address
823 N Columbus St
Lancaster, OH 43130-2549
Phone
(740) 654-6628
Fax
(740) 654-6578
NPI assigned
Feb 5, 2007
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
Oral and Maxillofacial Pathology Dentistry 1223P0106X 30019438 OH Primary

Addresses

Primary practice location

823 N Columbus St
Lancaster, OH 43130-2549

Mailing address

823 N Columbus St
Lancaster, OH 43130-2549
Phone (740) 654-6628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200318001411 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2668651126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30019438OHMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory C. Michaels D.D.S., M.S. Oral & Maxillofacial Surgery,Inc. Current Accepting new patients
Northeast Oral and Maxillofacial Surgery Past Accepting new patients

Locations

823 N Columbus St
Lancaster, OH 43130
Phone (740) 654-6628

Organizations & group practices 2

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396884805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 N COLUMBUS ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431302549",
            "telephone_number": "740-654-6628",
            "fax_number": "740-654-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 N COLUMBUS ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431302549",
            "telephone_number": "740-654-6628",
            "fax_number": "740-654-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "GREGORY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "OH",
            "license": "30019438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.