Individual provider Active NPI

Ronald Frank Gravitz, D.M.D.

  • Pediatric Dentistry
  • Rockville, MD
National Provider Identifier
1447272976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6317 Issued in MD
Practice address
15020 Shady Grove Rd
#360
Rockville, MD 20850-3364
Phone
(301) 762-2236
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

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
Pediatric Dentistry 1223P0221X 6317 MD Primary

Addresses

Primary practice location

15020 Shady Grove Rd
#360
Rockville, MD 20850-3364

Mailing address

15020 Shady Grove Road
#360
Rockville, MD 20850-3398
Phone (301) 762-2236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6317MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Dental LLC Past Accepting new patients
Ronald F. Gravitz, P.a. Pediatric Dentistry Past Accepting new patients

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447272976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15020 SHADY GROVE ROAD",
            "address_2": "#360",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503398",
            "telephone_number": "301-762-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15020 SHADY GROVE RD",
            "address_2": "#360",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503364",
            "telephone_number": "301-762-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVITZ",
        "first_name": "RONALD",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "6317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.