Max David Gosselin

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901600684 Issued in MI

Practice address

1536 Huron Springs LN
Commerce TWP, MI 48382-1281

Phone

(248) 496-2289

NPI assigned

Aug 31, 2020

Last updated

Aug 31, 2020By the provider in NPPES

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

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1265046023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 HURON SPRINGS LN",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483821281",
            "telephone_number": "248-496-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 HURON SPRINGS LN",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483821281",
            "telephone_number": "248-496-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "MAX",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• G. Daniel Shanahan IV DPM PC
• Alexander John Gammo, PHARMACIST
• Jennifer Gavia
• Blair Joseph Globerman, DC
• Margaret A Glynn, CRNA
• Susan Grant, CRNA
• Guidance Healthcare, PLLC
• Sara Hannoodi, DDS
• Kimberly B Hart, MD
• Heart 'and' Soul Therapy, LLC

• General Practice Dentistry in Commerce TWP, MI
• Providers in Commerce TWP, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.