Individual provider Active NPI

Gregory Bert Adair, DMD

  • Dentist
  • Gypsum, CO
National Provider Identifier
1679637862
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8496 Issued in CO
Practice address
35 Lindbergh Dr. Ste.107
Gypsum, CO 81637-4370
Phone
(970) 328-6848
Fax
(970) 328-1185
NPI assigned
Dec 21, 2006
Last updated
Jan 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8496 CO Primary

Addresses

Primary practice location

35 Lindbergh Dr. Ste.107
Gypsum, CO 81637-4370

Mailing address

PO Box 4370
Gypsum, CO 81637-4370
Phone (970) 328-6848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150610001574 CO Order and Referring Only - DentistPractitioner - Dentist 7618298068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8496COMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Altitude Family Dental, PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1679637862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4370",
            "city": "GYPSUM",
            "state": "CO",
            "postal_code": "816374370",
            "telephone_number": "970-328-6848",
            "fax_number": "970-328-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LINDBERGH DR. STE.107",
            "city": "GYPSUM",
            "state": "CO",
            "postal_code": "816374370",
            "telephone_number": "970-328-6848",
            "fax_number": "970-328-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAIR",
        "first_name": "GREGORY",
        "middle_name": "BERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "8496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gypsum, CO

Sources for this page

Verify at the official NPI Registry.