Organization Active NPI

Dr. Timothy Gross' Dental Excellence LLC

  • Dentist
  • Hilton Head Island, SC
National Provider Identifier
1619424264
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DGD4552 Issued in SC
Legal business name
DR. TIMOTHY GROSS' DENTAL EXCELLENCE LLC
Practice address
15 Bow Cir
Suite 104
Hilton Head Island, SC 29928-3211
Phone
(843) 342-7700
Fax
(843) 785-7804
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Authorized official

Name
Dr. Timothy Paul Gross, D.M.D.
Title
Owner/Doctor
Phone
(843) 342-7700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DGD4552 SC Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

15 Bow Cir
Suite 104
Hilton Head Island, SC 29928-3211

Mailing address

15 Bow Circle
Suite 104
Hilton Head Island, SC 29928-3211
Phone (843) 342-7700

National Provider Directory

National Provider Directory

Locations

15 Bow Cir
Ste 104
Hilton Head Island, SC 29928
Phone (843) 342-7700

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1619424264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BOW CIRCLE",
            "address_2": "SUITE 104",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299283211",
            "telephone_number": "843-342-7700",
            "fax_number": "843-785-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BOW CIR",
            "address_2": "SUITE 104",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299283211",
            "telephone_number": "843-342-7700",
            "fax_number": "843-785-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. TIMOTHY GROSS' DENTAL EXCELLENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "843-342-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "DGD4552",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.