Individual provider Active NPI

Howard B Gross, DDS, MSD

  • Dentist
  • Ardmore, PA
National Provider Identifier
1720139728
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS036734 Issued in PA
Practice address
32 Parking Plaza
The Times Building Suite 502
Ardmore, PA 19003
Phone
(610) 896-1780
Fax
(610) 896-1787
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DS036734 PA
Periodontics 1223P0300X 2901018790 MI
Dentist 122300000X DS036734 PA Primary

Addresses

Primary practice location

32 Parking Plaza
The Times Building Suite 502
Ardmore, PA 19003

Mailing address

32 Parking Plaza
The Times Building Suite 502
Ardmore, PA 19003
Phone (610) 896-1780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160815000180 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7517251564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS036734PAMDDentist
2901018790MIMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1720139728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 PARKING PLAZA",
            "address_2": "THE TIMES BUILDING SUITE 502",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "19003",
            "telephone_number": "610-896-1780",
            "fax_number": "610-896-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 PARKING PLAZA",
            "address_2": "THE TIMES BUILDING SUITE 502",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "19003",
            "telephone_number": "610-896-1780",
            "fax_number": "610-896-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "HOWARD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS036734",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901018790",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS036734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, PA

Sources for this page

Verify at the official NPI Registry.