Individual provider Active NPI

Gordon D Gross, D.D.S.

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1629038955
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1776 Issued in AZ
Practice address
2715 W Northern Ave
Suite 102
Phoenix, AZ 85051-6641
Phone
(602) 995-0280
Fax
(602) 864-9161
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 1776 AZ Primary

Addresses

Primary practice location

2715 W Northern Ave
Suite 102
Phoenix, AZ 85051-6641

Mailing address

2715 W Northern Ave
Suite 102
Phoenix, AZ 85051-6641
Phone (602) 995-0280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160329001979 AZ Order and Referring Only - DentistPractitioner - Dentist 8224335757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nature Health Clinics of Arizona Current Accepting new patients
Gordon D. Gross, D.D.S.,P.C. 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.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629038955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 W NORTHERN AVE",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516641",
            "telephone_number": "602-995-0280",
            "fax_number": "602-864-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 W NORTHERN AVE",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516641",
            "telephone_number": "602-995-0280",
            "fax_number": "602-864-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "GORDON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "1776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.