Individual provider Active NPI

Robert Claude Gano, DDS

  • General Practice Dentistry
  • Kalamazoo, MI
National Provider Identifier
1629290135
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
016317 Issued in MI
Practice address
5462 Gull Rd Suite 7
Kalamazoo, MI 49048
Phone
(269) 373-1999
Fax
(269) 373-1959
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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 016317 MI Primary

Addresses

Primary practice location

5462 Gull Rd Suite 7
Kalamazoo, MI 49048

Mailing address

11887 Cressey Rd
Plainwell, MI 49080
Phone (269) 664-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20161102000515 MI Order and Referring Only - DentistPractitioner - Dentist 4385922947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016317MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Robert C. Gano, D.D.S., P.C. General Practice Current Accepting new patients
Dr Robert C Gano, DDS General Practice PastSince Nov 6, 2022 Accepting new patients

Locations

5462 Gull Rd
Ste 7
Kalamazoo, MI 49048
Phone (269) 373-1999

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1629290135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11887 CRESSEY RD",
            "city": "PLAINWELL",
            "state": "MI",
            "postal_code": "49080",
            "telephone_number": "269-664-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5462 GULL RD SUITE 7",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49048",
            "telephone_number": "269-373-1999",
            "fax_number": "269-373-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANO",
        "first_name": "ROBERT",
        "middle_name": "CLAUDE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "016317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.