Active NPI
Dinu A Gray, DDS
- General Practice Dentistry
- Petaluma, CA
National Provider Identifier
1679660633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30433
- Practice address
- 701 Sonoma Mountain Pkwy
Suite E 1
Petaluma, CA 94954-8518 - Phone
- (707) 782-0789
- Fax
- (707) 782-9133
- NPI assigned
- Oct 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30433 | CA | Primary |
Addresses
Primary practice location
701 Sonoma Mountain Pkwy
Suite E 1
Petaluma, CA 94954-8518
Mailing address
188 Stanford Ave
Mill Valley, CA 94941-3546
Phone (415) 389-9566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30433 | Other | CA | DENTAL LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Firas J Husein DDS Inc | Past | Accepting new patients | |
| Petaluma Valley Dental | General Practice | Past | Accepting new patients |
| Santa Rosa Dental | General Practice | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dental Clinic/Center
- Petaluma, CA
- NPI 1649849423
-
- General Practice Dentistry
- Petaluma, CA
- NPI 1356438311
-
- General Practice Dentistry
- Santa Rosa, CA
- NPI 1043309727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679660633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 STANFORD AVE",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949413546",
"telephone_number": "415-389-9566",
"fax_number": "415-389-9563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 SONOMA MOUNTAIN PKWY",
"address_2": "SUITE E 1",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949548518",
"telephone_number": "707-782-0789",
"fax_number": "707-782-9133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "DINU",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "30433",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENCE",
"identifier": "30433",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.