Individual provider Active NPI

Gregory Lisk, D.D.S.

  • General Practice Dentistry
  • Pickerington, OH
National Provider Identifier
1922003441
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15775 Issued in OH
Practice address
9 Hill Rd N
Pickerington, OH 43147-2246
Phone
(614) 833-0805
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15775 OH Primary

Addresses

Primary practice location

9 Hill Rd N
Pickerington, OH 43147-2246

Mailing address

9 Hill Road
Pickerington, OH 43147
Phone (614) 833-0805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15775OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922003441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HILL ROAD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "43147",
            "telephone_number": "614-833-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HILL RD N",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431472246",
            "telephone_number": "614-833-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISK",
        "first_name": "GREGORY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "15775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickerington, OH

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

Verify at the official NPI Registry.