Active NPI
Richard E Gosse
- General Practice Dentistry
- Appleton, WI
National Provider Identifier
1285702415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 522G
- Practice address
- 2830 N Mason St
Appleton, WI 54914-1353 - Phone
- (920) 731-2356
- Fax
- (920) 731-5354
- NPI assigned
- Dec 4, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 522G | WI | Primary |
Addresses
Primary practice location
2830 N Mason St
Appleton, WI 54914-1353
Mailing address
2830 N Mason St
Appleton, WI 54914-1353
Phone (920) 731-2356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33671300 | Other | WI | MEDICAL ASSISTANCE(EDS) |
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 |
|---|---|---|---|
| 522G | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appleton Family Dentistry SC | General Practice | 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.
-
- General Practice Dentistry
- Appleton, WI
- NPI 1447325527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285702415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2830 N MASON ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549141353",
"telephone_number": "920-731-2356",
"fax_number": "920-731-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2830 N MASON ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549141353",
"telephone_number": "920-731-2356",
"fax_number": "920-731-5354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSSE",
"first_name": "RICHARD",
"middle_name": "E",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "522G",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE(EDS)",
"identifier": "33671300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.