Glenn N Gorab, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DI13023 Issued in NJ

Practice address

1439 Broad St
Clifton, NJ 07013-4221

Phone

(973) 778-7171

Fax

(973) 916-0696

NPI assigned

Dec 19, 2005

Last updated

Sep 25, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 1, 2016 through Mar 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clifton Oral & Maxillofacial Surgery, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Clifton, NJ
  • NPI 1740361724
  NPD (past) Authorized official

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1700862059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070134221",
            "telephone_number": "973-778-7171",
            "fax_number": "973-916-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070134221",
            "telephone_number": "973-778-7171",
            "fax_number": "973-916-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORAB",
        "first_name": "GLENN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI13023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sully Gisel Gomez, CPT
• Sherie L Gonter
• Elyana Marissa Gonzalez
• Good News Care Transport LLC
• Shenelle K Gooden, APN
• Evgeni Goriounov, D.D.S.
• Denise Desousa Gorski, LPC, LCADC
• Gotham City Orthopedics,LLC
• Neil Kamal Goyal, M.D.
• David Graber

• Oral and Maxillofacial Surgery (Dentist) in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.