Individual provider Active NPI

Casey J Gremore, D.D.S.

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1205182250
Registry record updated Sep 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08948 Issued in IA
Practice address
330 Laurel St
Suite 1400
Des Moines, IA 50314-3044
Phone
(515) 288-3543
Fax
(515) 288-7713
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08948 IA Primary

Addresses

Primary practice location

330 Laurel St
Suite 1400
Des Moines, IA 50314-3044

Mailing address

330 Laurel St
Suite 1400
Des Moines, IA 50314-3044
Phone (515) 288-3543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20130626000889 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698914430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08948IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Des Moines Dental Care, P.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473552000000",
    "number": "1205182250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LAUREL ST",
            "address_2": "SUITE 1400",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143044",
            "telephone_number": "515-288-3543",
            "fax_number": "515-288-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAUREL ST",
            "address_2": "SUITE 1400",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143044",
            "telephone_number": "515-288-3543",
            "fax_number": "515-288-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREMORE",
        "first_name": "CASEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2016-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.