NPIMap

Organization Active NPI

GRG Dental, PLLC

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1578237608
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GRG DENTAL, PLLC
Practice address
1414 E Michigan St
Orlando, FL 32806-4817
Phone
(407) 897-3406
Fax
(407) 895-8275
NPI assigned
Aug 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Authorized official

Name
Dr. Gary R Gibson, DMDNPI 1194248864
Title
Owner
Phone
(407) 897-3406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1414 E Michigan St
Orlando, FL 32806-4817

Mailing address

1414 E Michigan St
Orlando, FL 32806-4817
Phone (407) 897-3406

Other names 1

  • Gary Gibson Dental Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@garygibsondental.com Direct

National Provider Directory

National Provider Directory

Locations

1414 E Michigan St
Orlando, FL 32806
Phone (407) 897-3406

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1578237608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E MICHIGAN ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064817",
            "telephone_number": "407-897-3406",
            "fax_number": "407-895-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E MICHIGAN ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064817",
            "telephone_number": "407-897-3406",
            "fax_number": "407-895-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRG DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-897-3406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@garygibsondental.com",
            "affiliation": "N",
            "endpointDescription": "Practice Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1414 E Michigan St",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328064817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Gary Gibson Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.