Individual provider Active NPI

Paul Gaston, DDS

  • Dentist
  • Columbus, OH
National Provider Identifier
1013978956
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30018018 Issued in OH
Practice address
949 East Livingston Avenue
Columbus, OH 43205
Phone
(614) 252-3181
Fax
(614) 252-1549
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30018018 OH Primary

Addresses

Primary practice location

949 East Livingston Avenue
Columbus, OH 43205

Mailing address

949 E Livingston Ave
Columbus, OH 43205-2748
Phone (614) 252-3181

Other identifiers 1

IdentifierTypeStateIssuer
0600773MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170801001632 OH Order and Referring Only - DentistPractitioner - Dentist 2365761608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30018018OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1013978956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 E LIVINGSTON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052748",
            "telephone_number": "614-252-3181",
            "fax_number": "614-252-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 EAST LIVINGSTON AVENUE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43205",
            "telephone_number": "614-252-3181",
            "fax_number": "614-252-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTON",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30018018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600773",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.