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DR. ANDREW JACOB GROSS PHD DMD NPI 1629557012


NPI Information

NPI: 1629557012
Provider Name: DR. ANDREW JACOB GROSS, PHD, DMD
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
55 FRUIT ST., WANG AMBULATORY BLDG SUITE230
BOSTON, MA
ZIP 02114
Phone: (617) 726-2740
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DR. Andrew Jacob Gross, PHD, DMD is an oral and maxillofacial surgery dentist in Boston, MA with 6 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Andrew Jacob Gross, PHD, DMD NPI is 1629557012. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: ROSEMAN UNIV OF HLTH SCIENCES, COL OF DENTAL MED
Graduation Year:2018

The provider's business location address is:

55 FRUIT ST., WANG AMBULATORY BLDG SUITE230
BOSTON, MA
ZIP 02114-696
Phone: (617) 726-2740

The NPI 1629557012 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/7/2018 and was last updated on 6/20/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice10858402-8903UTAHNo
21223S0112XDentistOral and Maxillofacial Surgery11022TENNESSEENo
31223S0112XDentistOral and Maxillofacial Surgery10858402-9925UTAHNo
41223S0112XDentistOral and Maxillofacial SurgeryDN1859764MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.