Kevin D. Gross, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS7297 Issued in TN

Practice address

603 Highway 321 N Unit 20 BLDG 4
Lenoir City Prof. Park
Lenoir City, TN 37771-6575

Phone

(865) 986-4582

Fax

(865) 988-8398

NPI assigned

Jul 7, 2005

Last updated

Jun 24, 2021By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Foothills Oral and Maxillofacial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lenoir City, TN
  • NPI 1154407088
  Authorized official Same address or phone

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1720085483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 HIGHWAY 321 N UNIT 20 BLDG 4",
            "address_2": "LENOIR CITY PROF. PARK",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377716575",
            "telephone_number": "865-986-4582",
            "fax_number": "865-988-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 HIGHWAY 321 N UNIT 20 BLDG 4",
            "address_2": "LENOIR CITY PROF. PARK",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377716575",
            "telephone_number": "865-986-4582",
            "fax_number": "865-988-8398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1858 Crest Rd",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378044305",
            "country_code": "US",
            "telephone_number": "865-977-7110",
            "fax_number": "865-977-4132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "KEVIN",
        "middle_name": "D.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS7297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3226934",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Greene
• Lori L Greene
• Kristin C Gregory, PA-C
• Mikayla Breann Griffin
• Misty Beth Griffitts
• Paul Dwayne Gross, DDS
• Ana Cristina Guzman, CNA
• Jan Theodore Hahn, MD
• Kim Halcomb, R.PH.
• Melissa Halcomb, RMA

• Oral and Maxillofacial Surgery (Dentist) in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.