Active NPI
Robert Gyurko, D.M.D., PH.D.
- Periodontics
- Wakefield, MA
National Provider Identifier
1558519082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN1857646
- Practice address
- 725 Main St
Wakefield, MA 01880-5206 - Phone
- (781) 245-6966
- NPI assigned
- Sep 9, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN1857646 | MA | Primary |
Addresses
Primary practice location
725 Main St
Wakefield, MA 01880-5206
Mailing address
725 Main St
Wakefield, MA 01880-5206
Phone (781) 942-1145
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1857646 | MA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Nutile DDS Inc | Past | Accepting new patients | |
| Crystal Lake Dental PC | 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.
-
- General Practice Dentistry
- Wakefield, MA
- NPI 1700059441
-
- Dentist
- Wakefield, MA
- NPI 1134391634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1558519082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 MAIN ST",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018805206",
"telephone_number": "781-942-1145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 MAIN ST",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018805206",
"telephone_number": "781-245-6966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GYURKO",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-09",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "DN1857646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.