Active NPI
Gary Lynn Gotsch, D.D.S, M.S.D.
- Prosthodontics
- Fort Wayne, IN
National Provider Identifier
1174627749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 7341
- Practice address
- 4205 Hobson CT
Fort Wayne, IN 46815-8648 - Phone
- (260) 486-8778
- Fax
- (260) 486-7679
- NPI assigned
- Sep 12, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 7341 | IN | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
4205 Hobson CT
Fort Wayne, IN 46815-8648
Mailing address
4205 Hobson CT
Fort Wayne, IN 46815-8648
Phone (260) 486-8778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100181210A | Medicaid | IN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7341 | IN | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1174627749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 HOBSON CT",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468158648",
"telephone_number": "260-486-8778",
"fax_number": "260-486-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4205 HOBSON CT",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468158648",
"telephone_number": "260-486-8778",
"fax_number": "260-486-7679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTSCH",
"first_name": "GARY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.D.S, M.S.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-12",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "IN",
"license": "7341",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100181210A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.