Active NPI
Carl Jeffries Gustke, DDS
- Periodontics
- Washington, DC
National Provider Identifier
1245218320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 4328-015
- Practice address
- Comdt (CG-1122) U.S. Coast Guard
2100 2ND St. SW, Suite 5314
Washington, DC 20593 - Phone
- (202) 267-0801
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS027832L | PA | |
| Periodontics | 1223P0300X | 4328-015 | WI | Primary |
Addresses
Primary practice location
Comdt (CG-1122) U.S. Coast Guard
2100 2ND St. SW, Suite 5314
Washington, DC 20593
Mailing address
306 Mechanic St
Cape May Court House, NJ 08210-1828
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 |
|---|---|---|---|
| DS027832L | PA | MD | Periodontist |
| 4328-015 | WI | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1245218320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 MECHANIC ST",
"city": "CAPE MAY COURT HOUSE",
"state": "NJ",
"postal_code": "082101828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "COMDT (CG-1122) U.S. COAST GUARD",
"address_2": "2100 2ND ST. SW, SUITE 5314",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20593",
"telephone_number": "202-267-0801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTKE",
"first_name": "CARL",
"middle_name": "JEFFRIES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS027832L",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WI",
"license": "4328-015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.