Individual provider Active NPI

Brian Howard Gross, D.D.S

  • Dentist
  • Boca Raton, FL
National Provider Identifier
1720416613
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN14306 Issued in FL
Practice address
7015 Beracasa Way
Suite101
Boca Raton, FL 33433-3453
Phone
(561) 338-6411
Fax
(561) 368-9949
NPI assigned
Oct 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN14306 FL Primary

Addresses

Primary practice location

7015 Beracasa Way
Suite101
Boca Raton, FL 33433-3453

Mailing address

7015 Beracasa Way
Suite101
Boca Raton, FL 33433-3453
Phone (561) 338-6411

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

State licenses

LicenseStateTypeSpecialty
DN14306FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Boca Dental Group PA Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1720416613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 BERACASA WAY",
            "address_2": "SUITE101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333453",
            "telephone_number": "561-338-6411",
            "fax_number": "561-368-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 BERACASA WAY",
            "address_2": "SUITE101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333453",
            "telephone_number": "561-338-6411",
            "fax_number": "561-368-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "BRIAN",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-31",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN14306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.