Gabriel McCormick DMD PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

2343 Issued in MT

Legal business name

GABRIEL MCCORMICK DMD PLLC

Doing business as

Bozeman Dentistry

Practice address

115 W Kagy Blvd
Ste I
Bozeman, MT 59715-6027

Phone

(406) 586-7661

Fax

(406) 586-7662

NPI assigned

May 19, 2016

Last updated

May 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gabriel McCormick, DMD

Title

Owner/Member

Phone

(406) 586-7661

Specialties & licenses 1

Addresses

Other names 1

• Bozeman Dentistry Doing business as

Locations

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1245687250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W KAGY BLVD",
            "address_2": "STE I",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156027",
            "telephone_number": "406-586-7661",
            "fax_number": "406-586-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W KAGY BLVD",
            "address_2": "STE I",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156027",
            "telephone_number": "406-586-7661",
            "fax_number": "406-586-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABRIEL MCCORMICK DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "406-586-7661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "2343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bozeman Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.

Verify at the official NPI Registry.