Organization Active NPI

Gary R Nelson DDS MSD Inc

  • Prosthodontics
  • Mill Valley, CA
National Provider Identifier
1962693663
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
27624 Issued in CA
Legal business name
GARY R NELSON DDS MSD INC
Practice address
141 Camino Alto
Ste 3
Mill Valley, CA 94941
Phone
(415) 383-2200
Fax
(415) 383-2617
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Dr. Gary R Nelson, DDS MSD INC
Title
Dentist
Phone
(415) 383-2200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 27624 CA
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 27624 CA Primary

Addresses

Primary practice location

141 Camino Alto
Ste 3
Mill Valley, CA 94941

Mailing address

141 Camino Alto
Ste 3
Mill Valley, CA 94941
Phone (415) 383-2200

National Provider Directory

National Provider Directory

Locations

141 Camino Alto
Ste 3
Mill Valley, CA 94941
Phone (415) 383-2200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1962693663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 CAMINO ALTO",
            "address_2": "STE 3",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-383-2200",
            "fax_number": "415-383-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 CAMINO ALTO",
            "address_2": "STE 3",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-383-2200",
            "fax_number": "415-383-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY R NELSON DDS MSD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "415-383-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MSD INC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27624",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "27624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.