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NPI Code Detail

MEDICARE: DR. GARY WAYNE GUREN D.D.S.

MEDICARE: DR. GARY WAYNE GUREN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry14945OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2341940255030OTHEROHCASRESOURCE

General Provider Information

NPI Number : 1245292416
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY WAYNE GUREN D.D.S.
Provider Business Mailing Address
First Line : 320 BLOSSOM LN
Second Line :
City : ORANGE VILLAGE
State : OH
Zip : 44022-5108
Country : US
Telephone Number : 440-349-1188
Fax Number :
Provider Business Practice Location Address
First Line : 20508 SOUTHGATE PARK BLVD
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-2900
Country : US
Telephone Number : 216-663-2292
Fax Number : 216-663-2294
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2006
Last Update Date : 07/08/2007

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