Individual provider Active NPI

Raymond Gozon, DMD

  • General Practice Dentistry
  • Norfolk, VA
National Provider Identifier
1265043749
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN25071 Issued in FL
Practice address
1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803
Phone
(757) 687-9166
NPI assigned
Aug 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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 DN25071 FL Primary

Addresses

Primary practice location

1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803

Mailing address

1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20210630004247 VA Order and Referring Only - DentistPractitioner - Dentist 2365843174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN25071FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gozon Dental PLLC Current 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": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1265043749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 ADMIRAL TAUSSIG BLVD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235112803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 ADMIRAL TAUSSIG BLVD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235112803",
            "telephone_number": "757-687-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOZON",
        "first_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.