Individual provider Active NPI

John Amos Gasser, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Medina, OH
National Provider Identifier
1457404659
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
30 014291 Issued in OH
Practice address
805 E Washington St
Suite 120
Medina, OH 44256-3340
Phone
(330) 722-7416
NPI assigned
Jan 19, 2007
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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30 014291 OH Primary

Addresses

Primary practice location

805 E Washington St
Suite 120
Medina, OH 44256-3340

Mailing address

805 E Washington St
Suite 120
Medina, OH 44256-3340
Phone (330) 722-7416

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
30 014291OHMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9415/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457404659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E WASHINGTON ST",
            "address_2": "SUITE 120",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563340",
            "telephone_number": "330-722-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E WASHINGTON ST",
            "address_2": "SUITE 120",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563340",
            "telephone_number": "330-722-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASSER",
        "first_name": "JOHN",
        "middle_name": "AMOS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30 014291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

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.