Gregory R Verderber, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-01-8697 Issued in OH

Practice address

218 Stern Rd
Seaman, OH 45679-9607

Phone

(937) 386-1379

Fax

(937) 386-0129

NPI assigned

May 11, 2006

Last updated

Jul 23, 2009By 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)

Not enrolled

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1770533861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 DUPONT CIR",
            "address_2": "SUITE A",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451502793",
            "telephone_number": "513-576-7700",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 STERN RD",
            "city": "SEAMAN",
            "state": "OH",
            "postal_code": "456799607",
            "telephone_number": "937-386-1379",
            "fax_number": "937-386-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDERBER",
        "first_name": "GREGORY",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-01-8697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0689183",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Seaman, OH
• Providers in Seaman, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; 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.