Theodore C Gross, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

036441 Issued in NY

Practice address

12 Davis Ave
Poughkeepsie, NY 12603

Phone

(845) 473-4565

Fax

(845) 484-1721

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1770639213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 DAVIS AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "telephone_number": "845-473-4565",
            "fax_number": "845-484-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DAVIS AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "telephone_number": "845-473-4565",
            "fax_number": "845-484-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 Route 376 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Wappingers Falls",
            "state": "NY",
            "postal_code": "125907612",
            "country_code": "US",
            "telephone_number": "845-223-9987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "THEODORE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "036441",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "036441",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00722376",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena Grishkevich, MD
• Frankie Grixti
• Patricia Shannon Grogan, LPN
• Gross and Flores DDS PC
• Alan Gross, M.D.
• Gary David Grossman, MD
• Joanne Growney, RN, ANP-BC
• Samuel Grubb
• Catherine Gruszecki, PA
• Adrian J. Gruszko, M.D.

• Dentist in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.