NPIMap

Organization Active NPI

David a Gore DDS PLLC

  • Dental Clinic/Center
  • Granite Falls, WA
National Provider Identifier
1013521400
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DAVID A GORE DDS PLLC
Doing business as
Cerven Dental
Practice address
405 S Granite Ave
Granite Falls, WA 98252-8474
Phone
(918) 766-5312
NPI assigned
Sep 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Gore, DDSNPI 1952784365
Title
Dentist, Owner
Phone
(918) 766-5312

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

405 S Granite Ave
Granite Falls, WA 98252-8474

Mailing address

405 S Granite Ave
Granite Falls, WA 98252-8474
Phone (360) 691-7793

Other names 1

  • Cerven Dental Doing business as

National Provider Directory

National Provider Directory

Locations

405 S Granite Ave
Granite Falls, WA 98252
Phone (360) 691-7793

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1013521400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S GRANITE AVE",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528474",
            "telephone_number": "360-691-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S GRANITE AVE",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528474",
            "telephone_number": "918-766-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A GORE DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST, OWNER",
        "authorized_official_telephone_number": "918-766-5312",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cerven Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cerven Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granite Falls, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.