DR. JONATHAN RUSSELL GRAY DDS
NPI 1508048521
Dentist - Oral and Maxillofacial Surgery in Fargo, ND

Active since November 30, 2007PECOS EnrolledAccepts Medicare Assignment
4344 20TH AVE S, FARGO, ND 58103(701) 239-5969 Get Directions Write a Review

NPPES record last updated: August 19, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jonathan Russell Gray Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN RUSSELL GRAY DDS (NPI 1508048521) is an individual oral and maxillofacial surgery provider in Fargo, North Dakota, licensed in North Dakota (2096) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2007).

NPPES Registry Identity

NPI1508048521
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. JONATHAN RUSSELL GRAYCredential: DDS
Location Address4344 20TH AVE SFargo, ND 58103-7436
Mailing Address4344 20th Ave SFargo, ND 58103-7436 · (701) 239-5969
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2007
Enumeration DateNovember 30, 2007
Last NPPES UpdateAugust 19, 2011
NPI 1508048521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in ND · 2096
Definition
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.
4344 20TH AVE S, Fargo, ND 58103

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Jonathan Russell Gray Dds is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597933358
PECOS Enrollment IDI20110721000417
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $55.75 – $168.12
Typical copayment $21.42 (range $13.93 – $42.03)
Most-billed visit code 99203
Established Patient
$69.48 typical visit price
range $18.11 – $137.65
Typical copayment $17.37 (range $4.52 – $34.41)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Ambulatory Surgical)
4344 20TH AVE S
FARGO, ND 58103
Ophthalmology
4344 20TH AVE S
FARGO, ND 58103
Dentist (Oral and Maxillofacial Surgery)
4344 20TH AVE S, STE 2
FARGO, ND 58103
Clinic/Center
4344 20TH AVE S
FARGO, ND 58103
Eyewear Supplier
4344 20TH AVE S
FARGO, ND 58103
Ophthalmology
4344 20TH AVE S
FARGO, ND 58103
Dentist (Oral and Maxillofacial Surgery)
4344 20TH AVE S, SUITE 2
FARGO, ND 58103
Optometrist
4344 20TH AVE S
FARGO, ND 58103

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Gray's NPI number?

The NPI number for Jonathan Gray is 1508048521. It was assigned to this individual provider in the NPPES registry on November 30, 2007.

Where is Jonathan Gray located?

Jonathan Gray practices at 4344 20th Ave S, Fargo, ND 58103. The listed phone number is (701) 239-5969.

What is Jonathan Gray's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Jonathan Gray enrolled in Medicare?

Yes. Jonathan Gray is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jonathan Gray accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 2 other insurers list Jonathan Gray as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jonathan Gray was last updated on August 19, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.