Individual provider Active NPI

Neil Ira Ganz, DDS

  • General Practice Dentistry
  • Steamboat Springs, CO
National Provider Identifier
1982623617
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6852 Issued in CO
Practice address
440 S Lincoln Ave
Suite B10
Steamboat Springs, CO 80487-8916
Phone
(970) 879-5630
Fax
(970) 879-0703
NPI assigned
Jul 19, 2006
Last updated
Jul 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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 6852 CO Primary

Addresses

Primary practice location

440 S Lincoln Ave
Suite B10
Steamboat Springs, CO 80487-8916

Mailing address

440 S Lincoln Ave
Suite B10
Steamboat Springs, CO 80487-8916
Phone (970) 879-5630

Other identifiers 1

IdentifierTypeStateIssuer
65635701MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20151211000359 CO Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1254632524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6852COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Neil Ganz, D.D.S., P.C. General Practice Past Accepting new patients
Red House PastSince Nov 8, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1982623617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 S LINCOLN AVE",
            "address_2": "SUITE B10",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804878916",
            "telephone_number": "970-879-5630",
            "fax_number": "970-879-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 S LINCOLN AVE",
            "address_2": "SUITE B10",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804878916",
            "telephone_number": "970-879-5630",
            "fax_number": "970-879-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANZ",
        "first_name": "NEIL",
        "middle_name": "IRA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65635701",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Steamboat Springs, CO

Sources for this page

Verify at the official NPI Registry.