Individual provider Active NPI

Geoffrey Gerstner, DDS, MS, PHD

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1508232554
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901016010 Issued in MI
Practice address
1011 N University Ave
Biologic and Materials Sciences, School of Dentistry
Ann Arbor, MI 48109-1078
Phone
(734) 763-7717
NPI assigned
Aug 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901016010 MI Primary

Addresses

Primary practice location

1011 N University Ave
Biologic and Materials Sciences, School of Dentistry
Ann Arbor, MI 48109-1078

Mailing address

1011 N University Ave
Biologic and Materials Sciences, School of Dentistry
Ann Arbor, MI 48109-1078
Phone (734) 763-7717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190327000482 MI Practitioner - Dentist 2365782489

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2901016010MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1508232554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "address_2": "BIOLOGIC AND MATERIALS SCIENCES, SCHOOL OF DENTISTRY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-763-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "address_2": "BIOLOGIC AND MATERIALS SCIENCES, SCHOOL OF DENTISTRY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-763-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSTNER",
        "first_name": "GEOFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.