Individual provider Active NPI

William H Gerlach, DDS, PC

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1609919992
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15500 Issued in TX
Practice address
5425 W Spring Creek Pkwy
Suite 165
Plano, TX 75024-4236
Phone
(972) 964-1855
Fax
(972) 943-9301
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15500 TX Primary

Addresses

Primary practice location

5425 W Spring Creek Pkwy
Suite 165
Plano, TX 75024-4236

Mailing address

5425 W Spring Creek Pkwy
Suite 165
Plano, TX 75024-4236
Phone (972) 964-1855

Other identifiers 2

IdentifierTypeStateIssuer
1013219732OtherTXINDIVIDUAL NPI
752403988OtherTXTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150209000571 TX Order and Referring Only - DentistPractitioner - Dentist 6103058458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15500TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1609919992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY",
            "address_2": "SUITE 165",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244236",
            "telephone_number": "972-964-1855",
            "fax_number": "972-943-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY",
            "address_2": "SUITE 165",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244236",
            "telephone_number": "972-964-1855",
            "fax_number": "972-943-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLACH",
        "first_name": "WILLIAM",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS, PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1013219732",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "752403988",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.