Gary Michael Gradke, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1702 Issued in AZ

Practice address

6945 E Sahuaro Dr
Suite a-1
Scottsdale, AZ 85254-6722

Phone

(480) 998-7500

Fax

(480) 998-7889

NPI assigned

Mar 19, 2007

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment NPD
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831213164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6945 E SAHUARO DR",
            "address_2": "SUITE A-1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546722",
            "telephone_number": "480-998-7500",
            "fax_number": "480-998-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6945 E SAHUARO DR",
            "address_2": "SUITE A-1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546722",
            "telephone_number": "480-998-7500",
            "fax_number": "480-998-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADKE",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "1702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Zlaket Matta MD LLC
• Graceful Homes
• Graceful Living Chiropractic
• Graceward Recovery
• Patricia Arnold Grade, MD
• Gordon Louis Grado, M.D.
• Robert Ernest Grady III, MD
• Catherine Connell Graeff, R.PH.
• Jill Graf, MS, ACNP-BC, CCNS
• Logan Graf, DO

• Oral and Maxillofacial Surgery (Dentist) in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• 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.

Verify at the official NPI Registry.