Active NPI
Paul Timothy Gilmore, DDS
- Dentist
- Audubon, PA
National Provider Identifier
1063662609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS023489L
- Practice address
- 2795 Egypt Rd
Audubon, PA 19403-2268 - Phone
- (610) 631-5800
- NPI assigned
- Sep 19, 2008
- Last updated
- Sep 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS023489L | PA | Primary |
Addresses
Primary practice location
2795 Egypt Rd
Audubon, PA 19403-2268
Mailing address
2795 Egypt Rd
Audubon, PA 19403
Phone (610) 631-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS023489L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221782400000",
"number": "1063662609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2795 EGYPT RD",
"city": "AUDUBON",
"state": "PA",
"postal_code": "19403",
"telephone_number": "610-631-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2795 EGYPT RD",
"city": "AUDUBON",
"state": "PA",
"postal_code": "194032268",
"telephone_number": "610-631-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "PAUL",
"middle_name": "TIMOTHY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-19",
"last_updated": "2008-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS023489L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Audubon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.