Gregory Bert Adair, DMD
Individual provider Active NPI Dentist · Gypsum, CO
NPI 1679637862 · NPPES record last updated Jan 29, 2019
Key facts
- NPI
- 1679637862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 8496 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150610001574 | CO | Order and Referring Only - Dentist |
7618298068 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8496 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altitude Family Dental, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8496 | CO | Yes |
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
Other providers in Gypsum, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.