Pierre Jean Gosselin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN14408 Issued in FL

Practice address

9 St Johns Medical Park
Suite B
St Augustine, FL 32086-5343

Phone

(904) 797-4108

Fax

(904) 794-0355

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smilecare Dental Associates PA

  • Dentist
  • Jacksonville, FL
  • NPI 1629107537
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289001600000",
    "number": "1033265426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 GOLFSIDE DRIVE",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567793",
            "telephone_number": "904-367-1722",
            "fax_number": "904-367-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 ST JOHNS MEDICAL PARK",
            "address_2": "SUITE B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865343",
            "telephone_number": "904-797-4108",
            "fax_number": "904-794-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "PIERRE",
        "middle_name": "JEAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Daniel Gordon, DMD
• Tyrone M Gordon, RCSWI
• Nicole C Gortaire, DPM
• Jaimie Gosiker, BCBA
• Cody Scott Goslinga, D.M.D.
• Donna Browder Grace, P.T.
• Joseph Mark Graham, DO
• Kalma Rose Graham, A.P.
• Sydney Hope Sallach Grams, PT, DPT
• Amanda Ayer Grant, DPT

• General Practice Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.