Active NPI
Renie Madelon Gross, D.D.S
- Endodontics
- Silver Spring, MD
National Provider Identifier
1730256215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 10854
- Practice address
- 11239 Lockwood Dr
Silver Spring, MD 20901-4554 - Phone
- (301) 593-4400
- Fax
- (301) 593-1587
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 10854 | MD | Primary |
Addresses
Primary practice location
11239 Lockwood Dr
Silver Spring, MD 20901-4554
Mailing address
5225 Pooks Hill Rd
#1409N
Bethesda, MD 20814-2052
Phone (301) 897-3786
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160229002233 | MA | Order and Referring Only - Dentist | 3072818020 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10854 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730256215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5225 POOKS HILL RD",
"address_2": "#1409N",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208142052",
"telephone_number": "301-897-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11239 LOCKWOOD DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209014554",
"telephone_number": "301-593-4400",
"fax_number": "301-593-1587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "RENIE",
"middle_name": "MADELON",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MD",
"license": "10854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.