Chase James Gottschalk, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1002144-15 Issued in WI

Practice address

3440 Ohio St
Great Lakes, IL 60088-3155

Phone

(847) 688-2100

NPI assigned

Jun 27, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Modern Dentistry of Minnetonka PLLC

  • General Practice Dentistry
  • Minnetonka, MN
  • NPI 1134807878
  NPD Authorized official

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1194386300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 N PROSPECT AVE UNIT 406",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 OHIO ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600883155",
            "telephone_number": "847-688-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTSCHALK",
        "first_name": "CHASE",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002144-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saman Reza Gharib, DMD
• Mark David Gilberts, DDS
• Kathy Sue Gluzinski, RPH
• Edward NMN Goldsborough IV, IDC
• Eric Martin Gomez, M.D.
• Martin Louis Gottstine, DDS
• David Lawrence Green, D.D.S.
• Sang Soo John Grzesik, DDS
• Kelsie Lynn Hammac
• Peter Jerome Hammes, DDS

• Dentist in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.