Dr. Adam Grubler, DDS
Dentist in Bridgeport, WV. Individual provider (NPI-1).
NPI number1609213313
StatusActive
Last updated in NPPESMar 7, 2017
Details
- NPI
- 1609213313
- Entity type
- Individual (NPI-1)
- Name
- Dr. Adam Grubler
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 4, 2013
- Last updated
- Mar 7, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- Medicare opt-out
- Dec 7, 2015 to Dec 7, 2027
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 4048 | WV | Yes |
Practice location
1160 Johnson Ave104
Bridgeport, WV 26330-1487
Phone 304-842-2361
Mailing address
201 Stone Gate CirMorgantown, WV 26505-1803
Phone 304-639-4849
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 18 Dentist providers in Bridgeport · All 1,140 providers in Bridgeport
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