DR. JOHN R GISSAL (NPI# 1780645804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780645804 |
| Entity Type | Individual |
| Full Name | DR. JOHN R GISSAL |
| Credential | DDS |
| Practice Address |
3801 Glenkerry Ct Portage MI 49024-0718 |
| Practice Telephone | 2693231527 |
| Practice Fax Number | 2693231670 |
| Mailing Telephone | 2693231527 |
| Mailing Fax Number | 2693231670 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2010-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2901012966 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2990946 | 05 | |
| MI | 1644808 | 05 |
| Street Address |
3801 GLENKERRY CT |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-0718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164416194 | Kevin Donald Morse | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2005-09-06 |
| 1912069204 | Robert M Humphries | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-12-14 |
| 1265522262 | Kalamazoo Oral & Maxillofacial Surgery, P.C. | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-10-13 |
| 1245291368 | Timothy V Williams | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-03-29 |
| 1669433793 | Thomas A Slack | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-03-29 |
| 1952361594 | Christian L Kanar | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376705038 | David M. Wilson | Dentist | 3801 Glenkerry Ct Ste 2, Portage, MI 49024-0711 | 2008-06-25 |
| 1487712956 | Robert Eugene White | Dentist | 5939 Central Avenue, Portage, IN 46368-2946 | 2006-12-05 |
| 1164416194 | Kevin Donald Morse | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2005-09-06 |
| 1366512832 | David Scott Jardenil | Dentist | 3204 Lancer St, Ste. B, Portage, IN 46368-4490 | 2006-11-09 |
| 1265522262 | Kalamazoo Oral & Maxillofacial Surgery, P.C. | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-10-13 |
| 1245291368 | Timothy V Williams | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-03-29 |
| 1669433793 | Thomas A Slack | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-03-29 |
| 1952361594 | Christian L Kanar | Dentist | 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568080414 | Shawn J Kim | Dentist | 425 E Washington St Apt 811, Ann Arbor, MI 48104-2060 | 2020-07-08 |
| 1760008528 | Great Lakes Oral and Maxillofacial Surgery P.C. | Dentist | 2325 Summit Park Dr Ste D, Petoskey, MI 49770-8774 | 2020-06-17 |
| 1962969634 | Garfield Road Dental - 1 | Dentist | 41781 Garfield Rd, Clinton Township, MI 48038-1964 | 2019-02-28 |
| 1477903904 | Abed Yakan | Dentist | 2700 Martin Luther King Jr. Blvd., 358, Detroit, MI 48208-2576 | 2016-06-15 |
| 1811378508 | Christopher Niquette | Dentist | 2119 64th Street Sw, Byron Center, MI 49315-4931 | 2015-06-18 |
| 1528446069 | Douglas David Orzel | Dentist | 9021 N Rodgers Ct Se Ste A, Caledonia, MI 49316-7650 | 2015-05-17 |
| 1013321165 | Raymond James Hanna | Dentist | 3766 Elder Rd S, West Bloomfield, MI 48324-2534 | 2014-06-17 |
| 1831536861 | Claude Charles Lerose Jr. | Dentist | 20675 Mack Ave, Grosse Pointe Woods, MI 48236 | 2013-05-31 |
| 1821433566 | Curtis Cardon | Dentist | 5957 Harvey St Ste 200, Norton Shores, MI 49444-9737 | 2013-05-08 |
| 1043568694 | Nick Leone Dds PC | Dentist | 28018 Harper Ave., St. Clair Shores, MI 48081-1562 | 2012-08-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.