Organization Active NPI

Stephen L Gross DDS PC

  • General Practice Dentistry
  • Bismarck, ND
National Provider Identifier
1437285012
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1742 Issued in ND
Legal business name
STEPHEN L GROSS DDS PC
Practice address
204 W Thayer Ave
Suite B2
Bismarck, ND 58501-3772
Phone
(701) 223-8262
Fax
(701) 223-0733
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen Louis Gross, DDS
Title
President
Phone
(701) 223-8262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1742 ND Primary

Addresses

Primary practice location

204 W Thayer Ave
Suite B2
Bismarck, ND 58501-3772

Mailing address

204 W Thayer Ave
Suite B2
Bismarck, ND 58501-3772
Phone (701) 223-8262

Other identifiers 1

IdentifierTypeStateIssuer
40999MedicaidND

National Provider Directory

National Provider Directory

Locations

204 W Thayer Ave
Ste B2
Bismarck, ND 58501
Phone (701) 223-8262

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437285012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W THAYER AVE",
            "address_2": "SUITE B2",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013772",
            "telephone_number": "701-223-8262",
            "fax_number": "701-223-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W THAYER AVE",
            "address_2": "SUITE B2",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013772",
            "telephone_number": "701-223-8262",
            "fax_number": "701-223-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN L GROSS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-223-8262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40999",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.