Dr. Ross Evan Gruber, dds
Dentist, Pediatric Dentistry in East Patchogue, NY. Individual provider (NPI-1).
NPI number1720188071
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1720188071
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ross Evan Gruber
- Credential
- dds
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 25, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- 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 |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | 045321 | NY | Yes |
Practice location
285 Sills RdSuite 3b
East Patchogue, NY 11772-4869
Phone 631-289-9000 · Fax 631-289-9009
Mailing address
285 Sills RdSuite 3b
East Patchogue, NY 11772-4869
Phone 631-289-9000 · Fax 631-289-9009
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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.
Other Pediatric Dentistry providers in East Patchogue, NY
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