Gary P. Weller, DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

NC4417 Issued in NC

Practice address

825 Majestic CT
Ste. C
Gastonia, NC 28054-5186

Phone

(704) 864-6721

Fax

(704) 864-1175

NPI assigned

Nov 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gary P Weller DDS PA

  • General Practice Dentistry
  • Gastonia, NC
  • NPI 1912079930
  NPD (past) Authorized official
• Manish V Sheladia DMD

  dba Majestic Dentistry of Gastonia

  • Dental Clinic/Center
  • Gastonia, NC
  • NPI 1093140832
  NPD (past)

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770654832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 MAJESTIC CT",
            "address_2": "STE. C",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545186",
            "telephone_number": "704-864-6721",
            "fax_number": "704-864-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 MAJESTIC CT",
            "address_2": "STE. C",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545186",
            "telephone_number": "704-864-6721",
            "fax_number": "704-864-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "GARY",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "NC4417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8999096",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Webber, LCSWA
• Leah Webster
• Vickie B Webster, RDH
• Teryn Weeks
• Kristen White Welborne, DDS
• Wellington House
• Arielle Wellons, MA, LPCA
• Claire D Wells
• Denise Rae Wells, M.A., LPCA, ATR
• Jacquail Wells, LCSWA

• General Practice Dentistry in Gastonia, NC
• Providers in Gastonia, NC by specialty
• General Practice Dentistry in North Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.